Government Mandates Make Health Savings More Elusive

The Centers for Medicare and Medicaid Services recently released some data that show that the digital revolution continues to evade health care.

Through mid-May, just 1,026 registered hospitals and physicians out of a possible 56,599 have demonstrated that they are using electronic medical records and other health information technology in accordance with federal standards. That’s a scant 2%.

The federal government has tried to promote the switch from paper medical records to electronic ones in hopes of improving efficiency and bringing down health costs. It’s even putting money behind the push — some $27 billion over 10 years, or from $44,000 to $63,750 per physician and up to $2 million per hospital.

But even that vast sum of taxpayer lucre cannot will the necessary innovations into being.

Worse, like so many roads paved with good intentions, this one may yield some unfortunate consequences — paramount among them a decline in the number of doctors who will take Medicare patients.

A Rand Corporation study in 2005 concluded that health IT could save our health care system about $77 billion a year. Other studies have put annual savings in the $80 billion to $100 billion range.

The Rand study is popular with cost-cutters, but read the fine print: “much of the gains can only be achieved if all, or nearly all, of the healthcare organizations participate.”

At this stage, the cost of implementing health IT is a high threshold for many providers to cross. The average initial cost of an electronic health records (EHR) system is $44,000 per physician, with ongoing maintenance estimated at $8,500 a year.

Most physician office visits still occur in practices with 10 or fewer doctors. These aren’t just medicine men; they’re also small businesses, with the same concerns about remaining profitable as others. These health IT mandates only add a new level of complexity.

According to the head of the Business Management Department at North Carolina State University’s College of Management, “the main barriers to the adoption of EHR by small healthcare firms are due to legal and economic uncertainty.”

For years, politicians in Washington have been seeking a way to harness the savings from health IT. Each time they have tried, they ended up putting success further off.

In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA), predicting that portable health records would usher in a new golden age. Fifteen years later, we’re still waiting.

In 2004, President Bush signed Executive Order 13335 setting the goal of a nationwide health information network within ten years. Time is almost up, and government data show that only 1,026 registered hospitals and physicians — out of 56,599 — use technology that meets federal standards.

Washington politicians have spent years fiddling with carrots and sticks and regulations and mandates. In the process, they have gummed up the work that could have been done by the free market and private innovators.

If we want results, Washington needs to stop trying to legislate Star Trek-style medical tricorders into being. We’re better off leaving technology to the real-world innovators who have put communicators (er, rather, cell phones) into the hands of just about everyone.

Healthcare groups urge Congressional subcommittee to curb IPAB

Potential Medicare budget cuts made through a new board are likely to significantly reduce healthcare access for beneficiaries, according to testimony presented to the U.S. House Energy and Commerce health subcommittee.

The Healthcare Leadership Council, which includes the Pharmaceutical Research and Manufacturers of America (PhRMA) and numerous other healthcare-related groups, recently testified that the Independent Payment Advisory Board (IPAB) structure is likely to lead to payment cuts to healthcare providers. “The combination of payment cuts, along with the projected shortage of physicians the nation will experience over the next several years … will create a healthcare access ‘perfect storm’ that will hit seniors the hardest,” said HLC President Mary Grealy.

The IPAB must be repealed by Congress and not simply be “fixed,” Grealy said. “Because the IPAB recommendations can take effect without an affirmative vote from Congress, it will become the de facto decision-maker for future Medicare policies. It is a mistake to invest such power in an unelected board that needs to be responsive to the public,” Grealy said.

Healthcare groups are also concerned about the rigidity of the IPAB mandate, which automatically triggers spending reductions when spending exceeds arbitrary levels. “It does not take into consideration public health demands which may necessitate greater, not reduced, Medicare spending. It also does not recognize that new innovations in medical practice and pharmaceutical development — which may involve high up-front cuts and thus be a prime IPAB target — can actually reduce healthcare costs in the long run,” Grealy said.

Grealy told Congressional representatives that there are “better, more patient-centered” ways to curb Medicare spending. Those include solutions from the private sector and from the Centers for Medicare and Medicaid Services (CMS), which has implemented programs such as PACE (The Program of All-Inclusive Care for the Elderly), value-based purchasing, and bundling of payments.

Southern Cross landlord in move to run homes

NHP, the owner of 249 care homes operated by Southern Cross, is to establish a new company to run them, creating one of the biggest operators in the sector.

It will set up a joint venture with the healthcare consultancy Court Cavendish by the end of October, when Southern Cross is expected to be wound up, NHP said on Monday. Staff at the homes would keep their jobs, and it would take over some of Southern Cross’s existing back office services.

“This new operating company, which will rent and operate out of the properties that NHP currently leases to Southern Cross, will be robust and not subject to the same financial uncertainty that has challenged Southern Cross,” NHP said.

Southern Cross, Britain’s biggest care homes operator with 752 homes and 31,000 residents, said last week that it would be wound up over the next few months. The decision followed months of tense negotiations with landlords, after fee cuts and falling occupancy rates left it unable to meet its rent payments.

The company’s management had hoped that NHP would be an “anchor” landlord for a slimmed-down Southern Cross, but they abandoned efforts to keep the company afloat after NHP rejected the plan.

Chai Patel, chairman of Court Cavendish and former chief executive of the Priory Group, promised that the homes would undergo a “seamless transition”. He added that he would take a senior executive role in the new company, whose name has not yet been chosen, and that NHP was talking to “one or two” other landlords about taking over their homes.

”As a pure elderly care home operator, this will be the largest in Britain,” Mr Patel said. The fact that NHP would have a stake in the operating company, as well as being a landlord, would “allow greater flexibility in the way the rents are structured”, he added.

NHP has been run by Capita, the outsourcing group, since it was overwhelmed last year by debts of £1.1bn. Capita has allowed NHP to retain about £14m ($22.5m) of loan interest payments to allow the funds to be used for the new company’s working capital needs. The company also plans to retain the next wave of interest payments in October. This will give it an initial capital base of £30m, said Paul Thompson, an NHP director.

The announcement brings greater clarity on the long-term future of Southern Cross’s homes. Jamie Buchan, Southern Cross’s chief executive, called it “very positive indeed” and pledged to ensure a “professional and seamless handover”.

However, the fate of most other homes remains less clear. Four Seasons and Bondcare, two rival operators that own 85 Southern Cross homes between them, want to take over the homes themselves, and have also been in talks to take over other landlords’ homes. But neither has yet formally laid out its plans.

William Laing, chief executive of the healthcare consultancy Laing & Buisson, said that the new company would “have a large thing to swallow”.

“For Bondcare and Four Seasons to take over their homes – it’s not very many, so that’s fine. But to take on 250 care homes is biting off an awful lot.”

However, the fact that the new company’s landlord would have a stake in it meant that it stood a good chance of avoiding a Southern Cross-style financial crisis, he added.

Quebec medical residents quit teaching as labour dispute looms

Quebec’s medical residents abruptly stopped teaching in hospitals this week, warning their boycott will escalate into a full-fledge strike unless they reach a salary agreement with the provincial government.

“There will be more pressure tactics if the situation doesn’t get better. We are contemplating a strike if we don’t progress in the coming weeks,” said Dr. Charles Dussault, president of the Federation medecins residents du Quebec, which is expressing frustration with the pace of contract negotiations that have been going on for the past 14 months.

On Monday, residents suspended, indefinitely, all teaching activities, including clinical supervision of medical students in hospitals.

“There’s no more observation or teaching or presentation. We’re cutting every contact with medical students,” Dussault said.
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Residents spend about 10 to 12 hours a week training students, on top of 70-hour work weeks; now, that time will be diverted to patient care, he added.

“Instead of teaching, we will have more time for patients,” he said.

The association is calling on the government to recognize the essential role residents provide in medical training, he said.

“It’s not just the money; it’s the principle,” he said.

The move left hospitals scrambling to pick up the slack where the residents’ suspension of activities have left a gap.

An integral part of medical training is provided by residents, said Pierre Cossette, the Universite de Sherbrooke’s dean of medicine.

“Teaching is intimately linked to the daily work of residents, and it’s difficult to separate teaching and clinical work,” Cossette said.

Quebec’s faculties of medicine respect the residents’ right to negotiate better working conditions but there’s concern over what is happening, Cossette said.

“We’re hoping that it lasts as (briefly) as possible and we’re taking measures to minimize the impact,” he said. “We are mobilizing professors already in the hospitals.”

Residents are negotiating 16-hour work shifts after an arbitrator’s ruling last month said that scheduling residents to work 24 hours consecutively violates the Canadian Charter of Rights and Freedoms.

But the issue of salary — pegged at 37 per cent below the Canadian average, or about $15,000 — is at the heart of the stalled negotiations.

Ten years ago Quebec residents’ wages were on par with earnings of the average Canadian resident, Dussault said.

“That’s a huge gap,” he said. “We won’t be attracting medical students here.”

Suspended teaching as pressure tactics will not affect patient services, said Marie-Eve Bedard, spokeswoman for Quebec Health Minister Yves Bolduc.

The provincial Health Department is hoping to reach an agreement that satisfies both sides as quickly as possible, Bedard said.

“We recommend they make their views known at the negotiating table,” Bedard said.

The Legitimate Uses Of Medical Marijuana

Medical marijuana contains THC and other cannabinoids that have an analgesic effect. They are also known to have anti-tremor, anti-spasmodic, anti-convulsion, and anti-psychotic properties. In addition, it is also used for its anti-inflammatory, anti-emetic, and appetite-stimulating properties.

Medical marijuana is used to help stimulate the appetite of AIDs patients suffering from AIDs wasting syndrome and for those with eating disorders like anorexia. Medical marijuana is also used as an anti-inflammatory to help arthritis sufferers.

Medical marijuana is being researched for the use and relief with victims of brain injury, stroke, and multiple sclerosis patients. Medical marijuana is also used to treat general pain. It is also used to provide relief from nausea for chemotherapy patients.

In addition, medical marijuana has been used for treatment of schizophrenia to relieve symptoms of psychosis, glaucoma, and for treatment to relieve migraines and asthma. The healing properties of this medicinal plant are numerous and cover a wide range of ailments.

Dehaier Medical Systems Names Dr. Xiaoqing Wang New Chief Technology Officer

Dehaier Medical Systems Ltd. DHRM
-9.27% (“Dehaier” or
the “Company”), an emerging leader in the development, assembly, marketing and sale of medical devices and homecare medical products in China, today announced that Xiaoqing Wang, Ph.D., has been appointed Chief Technology Officer, effective July 8, 2011. Dr. Wang, who will report to Chief Executive Officer Mr. Chen Ping, replaces Mr. Yong Wang, who has resigned from the Company due to personal reasons.

“We are honored to have Dr. Wang join the Company. He brings Dehaier more than 20 years of biomedical engineering experience, which we believe will contribute tremendously to our R&D capabilities as well as our product development as we work to introduce innovative products for the homecare and professional medical device markets. We believe that Dr. Wang’s contributions will be invaluable as we work to expand our share of the homecare market, both domestically and internationally,” said Dehaier’s CEO Mr. Ping Chen.

“On behalf of Dehaier’s Board of Directors and management team, I would like to thank Mr. Wang for his eight years of service to our Company and the contributions he made toward the development and commercialization of our homecare medical products during that time. We wish him every success in his future endeavors,” Mr. Chen concluded.

Prior to joining Dehaier, Dr. Wang spent six years as the institute director of the Beijing Taijie Magneto-electrical Institute. From 1998 to 2005, Dr. Wang served as a chief engineer for Beijing Wandong Medical Equipment Co., Ltd. Dr. Wang has also held senior development and engineering roles at companies including Beijing Sekisui Trank Medical Technology Co., Ltd., Hangwei General Electric Appliance Medical System Co., Ltd. Beijing Xiekun Medical Instrument Co., Ltd. Dr. Wang holds an MBA from the University of International Business and Economics, a Ph.D. in biomedical engineering from the Institution of Biomedical Engineering of the Chinese Academy of Machine Science, and a Bachelor of Science degree in Physics from Peking University.

About Dehaier Medical Systems Ltd.

Dehaier is an emerging leader in the development, assembly, marketing and sale of medical products in China, including respiratory and oxygen homecare medical products. The company develops and assembles its own branded medical devices and homecare medical products from third-party components. The company also distributes products designed and manufactured by other companies, including medical devices from IMD (Italy), Welch Allyn (USA), HEYER (Germany), Timesco (UK), eVent Medical (US) and JMS (Japan). Dehaier’s technology is based on five patents and five software copyrights; additionally we have three pending patents and six pending software copyrights, and proprietary technology. More information may be found at http://www.chinadhr.com .

Forward-looking Statements

This news release contains forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. Forward-looking statements include statements concerning plans, objectives, goals, strategies, future events or performance, and underlying assumptions and other statements that are other than statements of historical facts. These statements are subject to uncertainties and risks including, but not limited to, product and service demand and acceptance, changes in technology, economic conditions, the impact of competition and pricing, government regulation, and other risks contained in reports filed by the company with the Securities and Exchange Commission. All such forward-looking statements, whether written or oral, and whether made by or on behalf of the company, are expressly qualified by the cautionary statements and any other cautionary statements which may accompany the forward-looking statements. In addition, the company disclaims any obligation to update any forward-looking statements to reflect events or circumstances after the date hereof.

Health Buzz: Diabetes Rapidly Rising Worldwide

Diabetes Cases Double to 347 Million Worldwide

Nearly 10 percent of adults worldwide have diabetes, and new research suggests the rate of new cases is rising rapidly. Over the past three decades, the number of adults with either type 1 or type 2 diabetes worldwide has more than doubled, jumping from 153 million in 1980 to 347 million today. (Type 1 diabetes means the body produces too little or no insulin, while type 2 is linked to excess weight or inactivity.) About 70 percent of the increase is due to an aging population—since diabetes typically hits in middle age—while the remaining 30 percent is explained by the obesity epidemic, according to a study published Monday in the Lancet. Perplexingly, the incidence rate is rising twice as fast in the United States as it is in Western Europe, though researchers don’t yet understand why. “This is likely to be one of the defining features of global health in the coming decades,” study author Majid Ezzati, an epidemiologist and biostatistician at Imperial College London, told The Washington Post. “There’s simply the magnitude of the problem. And then there’s the fact that unlike high blood pressure and high cholesterol, we don’t really have good treatments for diabetes.”

6 Common Myths and Misconceptions About Diabetes

There are many mistaken beliefs about diabetes. Sue McLaughlin, former president of healthcare and education at the American Diabetes Association, offered her opinion of what she says are the six most common myths and misconceptions about diabetes, based on an ADA survey of more than 2,000 Americans released in 2009.

1. Diabetes is not that serious. In fact, diabetes causes more deaths than breast cancer and HIV/AIDS combined, McLaughlin says. Still, people with type 2 diabetes—the most common form of the disease—may go a long while, even years, before being diagnosed because they may downplay their symptoms or write them off to other causes. So if you are making frequent trips to the bathroom at night; experience extreme thirst, overwhelming fatigue, or blurry vision; or notice that you keep getting infections, ask your doctor to test you for diabetes. An early diagnosis can help ward off complications.

Are You Diabetic? 6 Tips That Will Help Keep You Out of the Hospital

Diabetes-related complications are among the most common reasons for hospitalization, according to a recent study in the Journal of Women’s Health. Researchers found that in 2006, for example, diabetics hospitalized because of congestive heart failure accounted for more than 1 in every 16 discharges; diabetics with pneumonia made up another 1 in 26. Moreover, the overall rate of hospital admissions for diabetics is rising—up more than 65 percent between 1993 and 2006. And it will climb even faster if the Centers for Disease Control and Prevention’s recent estimate that as many as 1 in 3 Americans, up from 1 in 10 now, will have type 1 or type 2 diabetes by 2050 holds up. For those who already have the disease, though, there is hope, U.S. News’s Kurtis Hiatt reported in October 2010.

Elderly blamed for long hospital waiting lists

HEALTH Minister Nicola Roxon has blamed the increase in the number of older Australians for the failure of her reforms to cut hospital waiting lists three years after they were introduced.

Ms Roxon yesterday conceded elective surgery waits were getting longer despite a $600 million federal spending boost, but said things would be worse if the money had not been spent.

The concession comes shortly before Ms Roxon receives a blueprint detailing potential trouble spots with the implementation of Labor’s health reforms based on a two-day workshop conducted by the Australian Healthcare and Hospitals Association.

The results show more guidance is needed on how Medicare Locals will work, where commonwealth funding to the states will be directed and whether hospitals will face a crushing red-tape burden reporting to different performance authorities.

A COAG reform council report released earlier this month found the time it took to treat 50 per cent of those waiting for elective surgery rose from 34 to 35 days in 2009-10.

The median wait for a coronary artery bypass went from 14 to 15 days and the wait time for knee surgery leapt from 156 to 180 days.

“Those figures would be even worse if the commonwealth had not made those investments for the first time ever directly in elective surgery,” Ms Roxon said.

More than 70,000 extra elective surgery procedures were undertaken with the extra commonwealth money, she said.

“As the population booms and ages we know we are facing a trend which had health pressures going like this, whether it’s costs, whether it’s numbers of procedures, whether it’s people present,” Ms Roxon said.

The states have agreed to improve their elective surgery performance and treat 95 per cent of patients within clinically recommended times by December 2015.

AHHA executive director Prue Power, who will deliver a report to Ms Roxon in coming weeks on the health reforms, said the government needed to explain how hospitals would report to and work with Medicare Locals.

Health economist Professor John Goss, who attended the AHHA’s two-day workshop last week, said the reforms could skew treatment towards hospitals, raising costs and admissions.

Medical pot industry group asks judge to block law

Medical marijuana patients and their health providers urged a judge Monday to block a new law that will eliminate commercial pot operations, saying they will have problems obtaining the drug after this month.

A medical marijuana industry group have called the new law unconstitutional and asked Helena District Judge James Reynolds for an injunction before July 1, when pot providers will be barred from making a profit and limited to providing marijuana to just three patients.

The new law also places additional checks on conditions for qualifying for the drug and on the doctors who certify medical marijuana patients.

State attorneys say the law will scale back an out-of-control industry while leaving seriously ill patients with access to the drug. But some patients and their loved ones say it will just force them to make illegal purchases by shutting down legitimate resources.

“The more I read about it the more absurd it is. They’re just trying to eliminate marijuana in Montana,” said Charlie Hamp, 79.

Hamp testified that his wife Shirley, 78, stirs a medical marijuana tincture into her morning coffee at home in Bozeman as a way to relieve the pain after her esophagus was removed and replaced with the lining of her stomach.

Charlie Hamp isn’t sure whether his wife will still be able to get that tincture from her provider after July 1, or whether the provider will be in business at all. Neither one of them knows how to make the tincture, nor do they want to ask their daughter and son-in-law to do it for them.

Montana Cannabis Industry Association attorney James Goetz said the main problem with the law is it will deny patients like Shirley Hamp access to medical marijuana. But it also will intrude upon the doctor-patient relationship and allow warrantless searches of patients and providers, he said.

“Marijuana, while not completely harmless, is remarkably safe. It has proven medicinal qualities. If a Montana citizen, in consultation with his or her doctor, wishes to have access to medical marijuana, that person should have access without undue governmental restraint,” Goetz said.

Assistant Attorney General Jim Molloy defended the new law, saying it is in line with what voters intended when they passed the state’s medical marijuana initiative in 2004. Seriously ill patients will still be able to grow the drug, hire a consultant to show them how, or have somebody grow it for them, he said.

“This is a lawsuit, your honor, about preserving the commercial marijuana industry that sprung up in Montana beginning in about 2008,” he said.

The hearing is expected to last through Tuesday, and it was not clear whether Reynolds will immediately make a ruling. The judge said he wants to know what would happen to medical marijuana regulations in Montana if the new law is blocked.

The Legislature passed its restrictive law in an attempt to rein in a booming medical marijuana industry that lawmakers say has been abused by recreational users and for-profit commercial entities. The bill’s passage this spring coincided with a series of raids against medical marijuana distributors in which drugs, cash and weapons were seized, causing several providers to shut down.

There are more than 30,000 medical marijuana users in Montana, with the start of the boom coinciding with a 2009 U.S. Department of Justice memo saying the federal government would not prosecute seriously ill patients who are following their states’ medical marijuana laws.

The number of people between 18 and 30 claiming chronic pain as the qualifying condition to become a medical marijuana patient – about 30 percent of the total number of users in Montana – indicates the users are not simply those with debilitating illnesses, Molloy said.

Medical marijuana users as a percentage of total adult population in Montana compared to other states is another indicator that something is amiss, Molloy said. Just over 4 percent of Montana adults are registered users, compared to .76 percent in Hawaii, 1 percent in Michigan and 1.34 percent in Oregon, he said.

“The situation is out of control, the Montana Legislature responded to it,” Molloy said.

Goetz said the law represents excessive governmental interference and that any law restricting rights must be scrutinized.

To support his case, he called two patients, three doctors, a social worker and a Harvard professor as witnesses about marijuana’s medicinal effects and the potential negative effects if the new law is allowed to take effect.

Bozeman oncologist Jack Hensold said he recommends medical marijuana to about three or four cancer patients a month to help them deal with nausea and other effects of cancer treatments.

He said he is concerned about the restrictions the law would impose and whether certain patients would be able to access the drug in the short term.

Cancer patient Pointe Hatfield said buying his medical marijuana from a provider is not a convenience, it’s a necessity. He tried to grow his own before, but the plants just died.

That’s why Hatfield, a 60-year-old Gardiner resident whose cancer is in remission, is worried how he will get his medical marijuana when a ban on commercial pot operations takes effect in Montana next month, patients and health officials told the judge.

Hatfield said he can’t understand why, if the state of Montana certifies him to use medical marijuana, he can’t go buy that drug just like getting a prescription filled at pharmacy.

“It’s the same as going to the drug store for an aspirin,” he said

A twist in Obama’s health care law

President Barack Obama’s health care law would let several million middle-class people get nearly free insurance meant for the poor, a twist government number crunchers say they discovered only after the complex bill was signed.

The change would affect early retirees: A married couple could have an annual income of about $64,000 and still get Medicaid, said officials who make long-range cost estimates for the Health and Human Services department.

Up to 3 million more people could qualify for Medicaid in 2014 as a result of the anomaly. That’s because, in a major change from today, most of their Social Security benefits would no longer be counted as income for determining eligibility. It might be compared to allowing middle-class people to qualify for food stamps.

Medicare chief actuary Richard Foster says the situation keeps him up at night.

“I don’t generally comment on the pros or cons of policy, but that just doesn’t make sense,” Foster said during a question-and-answer session at a recent professional society meeting.

“This is a situation that got no attention at all,” added Foster. “And even now, as I raise the issue with various policymakers, people are not rushing to say … we need to do something about this.”

Indeed, administration officials and senior Democratic lawmakers say it’s not a loophole but the result of a well-meaning effort to simplify rules for deciding who will get help with insurance costs under the new health care law. Instead of a hodgepodge of rules, there will be one national policy.

“This simplification will stop people from falling into coverage gaps and may cause some to be newly eligible for Medicaid and others to no longer qualify,” said Brian Cook, spokesman for the Centers for Medicare and Medicaid Services.

But states have been clamoring for relief from Medicaid costs, complaining that just these sorts of federal rules drive up spending and limit state options. The program is now one of the top issues in budget negotiations between the White House and Congress. Republicans are pushing for a rollback of federal requirements that block states from limiting eligibility.

Medicaid is a safety net program that serves more than 50 million vulnerable Americans, from low-income children and pregnant women to Alzheimer’s patients in nursing homes. It’s designed as a federal-state partnership, with Washington paying close to 60 percent of the total cost.

Early retirees would be a new group for Medicaid. While retirees can now start collecting Social Security at age 62, they must wait another three years to get Medicare, unless they’re disabled.

Some early retirees who worked all their lives may not want to be associated with a health care program for the poor, but others might see it as a relatively painless way to satisfy the new law’s requirement that all Americans carry medical insurance starting in 2014. It would help tide them over until they turn 65 and qualify for Medicare.

The actuary’s office said the 3 million early retirees who would become eligible for Medicaid are on top of an estimated 16 million to 20 million people that Obama’s law would already bring into the program, by opening it to childless adults with incomes near the poverty level. Federal taxpayers will cover all of the initial cost of the expansion.

A spokeswoman for the Senate Finance Committee, which wrote much of the health care law, said if the situation does become a problem there’s plenty of time to fix it later.

“These changes don’t take effect until 2014, so we have time to review all possible cases to ensure Medicaid meets its mission of serving only the neediest Americans,” said Erin Shields.

But Republicans already see a problem.

Former Utah governor Mike Leavitt said adding early retirees will “just add fuel to the fire,” bolstering the argument from Republican governors that some of Washington’s rules don’t make sense.

“The fact that this is being discovered now tells you, what else is baked into this law?” said Leavitt, who served as Health and Human Services secretary under President George H.W. Bush. “It clearly begins to reveal that the nature of the law was to put more and more people under eligibility for government insurance.”

The Medicare actuary’s office roughed out some examples to illustrate how the provision would work. A married couple retiring at 62 in 2014 and receiving the maximum Social Security benefit of $23,500 apiece could get $17,000 from other sources and still qualify for Medicaid with a total income of $64,000.

That $64,000 would put them at about four times the federal poverty level, which for a two-person household is $14,710 this year. The Medicaid expansion in the health care law was supposed to benefit childless adults with incomes up to 133 percent of the poverty level. A fudge factor built into the law bumps that up to 138 percent.

The actuary’s office acknowledged its $64,000 example would represent an unusual case, but nonetheless the hypothetical couple would still qualify for Medicaid.

Cancer costs put treatments out of reach for many

The skyrocketing cost of new cancer treatments is putting advances in fighting the deadly disease out of reach for a growing number of Americans.

Cancer patients are abandoning medical care because the costs are simply too high and medical bills — even among the insured — are unmanageable, studies show.

“There’s a growing awareness that the cost of cancer treatment is unsustainable,” said Dr. Lee Schwartzberg, an oncologist who did a study examining the factors that contributed to patients quitting their oral cancer drugs.

Cancer is one of the most costly diseases to treat.

“When it’s an expensive drug, we have to have the hard discussion about a very substantial out-of-pocket payment. I ask: ‘Do you want to spend this money for an average improvement of just a few months of life?’ I’m very uncomfortable having those discussions because I want to focus on the patient getting better,” Schwartzberg, medical director of the West Clinic in Memphis, Tenn., said in an interview.

Schwartzberg’s and other cost studies presented at the American Society of Clinical Oncology (ASCO) annual meeting come as U.S. lawmakers battle over ways to reduce the national debt, including cuts in healthcare funding.

ASCO president Dr. Michael Link, a pediatric oncologist, said access to healthcare should be a national priority.

INSURMOUNTABLE BARRIERS

“We’re thrilled with what we consider to be breakthroughs and wonderful new therapies … yet the barriers for some patients to get them is insurmountable. It is an indictment of how we take care of patients in the United States,” Link said.

Cancer is the second-leading cause of death in the United States, after heart disease. The incidence is expected to increase with an aging population.

The costs for cancer care topped $124 billion in 2010 in the United States, led by breast cancer, according to the National Cancer Institute (NCI). That number is expected to rise as more advanced treatments — targeted therapies that attack specific cancer cells and often have fewer side effects — are adopted as the standards of care. The NCI projects those costs to reach at least $158 billion by 2020.

Until recently, almost all cancer drugs were administered intravenously. Today, about a quarter of them can be given orally, which means fewer visits to the doctor. But pills are often more expensive, have higher co-payments, and are reimbursed by insurers at lower rates than IV drugs, he noted.

Using a database of pharmacy claims paid by private insurers and Medicare, he found, not surprisingly, that those with higher co-payments quit their drugs more often.

Patients with co-payments of more than $500 were four times more likely to abandon treatment than those with co-payments of $100 or less, Schwartzberg said. Claims with the highest co-payments had a 25 percent abandonment rate, compared with 6 percent for co-payments of less than $100.

“Prices of drugs can’t be set so outrageously high,” he said. “We have a problem with cancer care … All stake holders have to get together and compromise to translate this great science into great patient care without breaking the bank.”

Dr. Yousuf Zafar, an internist at Duke University Health System, did a separate study on the impact high medical bills have on patients’ cancer treatment.

THE INSURED ALSO STRUGGLE

The thing that surprised him most, Zafar said, was how much the insured struggled with their medical bills.

“Ninety-nine percent of the patients in our study were insured and 83 percent said they had prescription coverage. People still couldn’t afford groceries and were spending life savings on cancer care,” Zafar said.

Even with health insurance, out-of-pocket expenses averaged $712 per month for co-payments for doctor visits, prescription drugs, lost wages, travel to appointments and other expenses.

Jean Holstein, 55 of Jackson, North Carolina, has Stage IV breast cancer. She has health insurance, but fears the co-payments to cover her $5,000 per month drug regimen, plus the $9,700 bimonthly diagnostic scans, will leave her broke.

“The joke is that when you get cancer, you go spend all this money and live it up,” she said.

Rates of medical debt are growing, mainly among the insured. According to the American Cancer Society (ACS), 1 in 5 privately insured Americans with chronic conditions have problems paying their medical bills. When out-of-pocket spending for medical care exceeds 2.5 percent of income, financial burdens become substantial.

RISK OF BANKRUPTCY

Dr. Scott Ramsey authored a study that examined a cancer diagnosis as a risk for personal bankruptcy. Using cancer registries and bankruptcy records in Washington state, he found that a diagnosis of lung cancer had the highest risk of bankruptcy — 8 percent versus 0.3 percent in the general population in the same geographic area.

“We looked at (bankruptcy) 1, 3 and 5 years after a diagnosis and the rate ranged from two to six times higher,” he said.

Dr. Kevin Ennis, a radiation oncologist at St. Luke’s-Roosevelt and Beth Israel Medical Center in New York, studied the impact a weak economy has on the diagnosis and treatment of cancer. He said he found exactly what he had expected: There was a dramatic decline in cancer treatment during times of high unemployment.

Ennis looked at data from 1973 to 2007, the latest year for which data were available, and found that every 1 percent increase in unemployment was associated with a 7.4 percent decrease in diagnoses, a 16.8 percent decrease in radiation treatment and a 23.9 percent decrease in surgery.

“I suspect the recession we just had would have had an even more dramatic impact,” Ennis said.

Dr. Otis Brawley, the chief medical officer for the ACS, said the whole American medical system needs to be overhauled.

“We need to change the culture of doctors and patients and how medicine is practiced. I wish it were as simple as (enacting) legislation,” he said.

Medical Monday: Breast cancer wonder drug?

Breast cancer is the second leading cause of cancer deaths in women, but a new drug is promising to reduce the risk of developing invasive breast cancer by 65%.

In this Medical Monday segment, Dr. Morgan Sauer from The Longevity Center at St. Vincent is talking about this new drug and whether it’s really effective.

Aromasin is one of three drugs in a class called aromatase inhibitors. These drugs block the production of estrogen which can stimulate the development of breast cancer. Unlike the others, aromasin has fewer side effects that the other which increase the risk of uterine cancer and blood clots.

According to Dr. Sauer, this is the first study to show that drugs like aromasin have the ability to prevent breast cancer in high risk women. However, aromasin can cause hot flashes, arthritis, and cause loss of bone. When you look at the data, you have to treat 95 women in order for just one woman to have any benefit. Dr. Sauer recommends that it should probably only be used in women at very high risk for cancer.

The patent on aromasin has recently expired, thus opening the doorway for generic manufacturing of this drug. It is best for women to talk to their primary care physician about considering this or other treatments for prevention of breast cancer.

MidMichigan Medical Center-Gratiot Cancer Survivor Day signifies new life

In 2006 Shirley Lilly was first diagnosed with ovarian cancer.

By 2009 she was cancer free.

In 2010 it had come back and attacked her liver.

Today Lilly is cancer free and is the true definition of a survivor.

“In ‘06 I went through the regular chemo for six months and then I did a years treatment to stop me from ever getting it again,” Lilly said.

“I got it again and went through another year of that chemo. Now they keep track of me by my blood. I see the doctor now every three months.”

Sunday afternoon Lilly and many others attended MidMichigan Medical Center – Gratiot’s eleventh annual Cancer Survivor Day.

According to National Cancer Survivors Day website, “National Cancer Survivors Day is an annual, treasured worldwide Celebration of Life that is held in hundreds of communities throughout the United States, Canada, and other participating countries.”

“Participants unite in a symbolic event to show the world that life after a cancer diagnosis can be meaningful and productive.”

100 jobs to be created in Roscommon

More than 100 jobs are to be created in Roscommon with the expansion of the US medical devices company, Harmac.

More than 100 jobs are to be created in Roscommon with the expansion of US medical devices company Harmac.

The company already employs over 180 people at its Irish base in in Castlerea.

Harmac has been in operation in Castlerea since 1998.

Today’s jobs announcement marks significant expansion plans by the company with the facility being extended by 10,000sq.ft.

Recruitment is already under way for 100 new jobs, which will be filled over the next five years.

The Minister for Enterprise, Jobs and Innovation said he hoped that today’s announcement could be replicated around the country in the coming years.

Richard Bruton said last week’s jobs initiative was a first step in developing ambitious plans to grow the economy and create jobs.

IDA chief executive Barry O’Leary said the expansion of Harmac would build on the strong medical device cluster in the Midlands Gateway.

Whiny IMF head finally agrees to medical exam; set for arraignment today

The IMF chief who allegedly sodomized a Manhattan hotel maid proved the height of pompous arrogance yesterday, throwing a fit over a battle on his bail — which left him parked on a wooden bench in an East Harlem station house the whole day, sources said.

Leading French presidential contender and accused sex attacker Dominique Strauss-Kahn, 63, was finally led out of the NYPD’s Special Victims Unit at around 11 p.m. in handcuffs, scowling and red-faced.

Sporting a long navy-blue coat and an open collar, he refused to acknowledge reporters as he was placed in the back of a police car and whisked off to Kings County Hospital in Brooklyn.

Sources said he was taken out of the police station house only after finally agreeing to a medical exam — and only after cops had moved to obtain a warrant to gather potential DNA evidence.

Clues they’re looking for include possible DNA from his alleged victim that might be found in scratches on his body.

He had been set for arraignment last night, but one of his lawyers, Bill Taylor, at a hastily called press conference outside Manhattan Criminal Court, said:

“Our client willingly consented to a scientific and forensic examination . . . at the request of the government. It’s being done. In light of the hour, we’ve agreed to postpone the arraignment until [this morning], and we expect to be in court with him.”

Asked how Strauss-Kahn was doing, Taylor replied, “He’s tired, but he’s fine.”

Strauss-Kahn, 63, is accused of sexually assaulting and attempting to rape a maid at the Sofitel hotel near Times Square Saturday afternoon as she tried to clean his room.

Another one of his high-powered lawyers, Ben Brafman, said Strauss-Kahn “intends to vigorously defend these charges, and he denies any wrongdoing.”

Earlier in the day, Strauss-Kahn was outraged that he wasn’t getting the VIP treatment he’s accustomed to as the jet-setting head of the International Monetary Fund and darling of the French left, a police source told The Post.

Cops “are not thrilled by the French idiot, or his attorney,” Brafman, the source said.

Strauss-Kahn, one of the world’s wealthiest and most powerful moneymen, had been forced to cool his heels in the lockup of the NYPD’s Special Victims Unit in East Harlem as Brafman and celebrity bondsman Ira Judelson faced off with the Manhattan DA’s Office over a bail package, sources said.

The dingy digs, where prisoners are allotted $1.80 per meal, were a far cry from the $3,000-a-night luxury suite that Strauss-Kahn had been enjoying at the Sofitel New York only a day earlier.

The whiny fat cat had to tough it out after an assistant district attorney backtracked after initially offering the suspected sex fiend $250,000 bail — on the direct order of the prosecutor’s boss, Manhattan DA Cyrus Vance Jr., sources said.

As of last night, Vance was seeking bail of up to $2 million, plus the stipulation that Strauss-Kahn wear an ankle bracelet. His passport has already been confiscated.

“The concern of the DA’s office is there is no extradition treaty with France, and this guy could pull a Polanski,” the source said, referring to director Roman Polanski, who faced a child-sex rap in California in 1977 and remained on the lam in France for more than 30 years.

Strauss-Kahn, a leading Socialist who was expected to challenge French President Nicolas Sarkozy in the 2012 election, faces charges of attempted rape, criminal sexual assault and unlawful imprisonment. He could land up to 20 years in prison, if convicted.

In an ironic twist, Strauss-Kahn may have inadvertently helped cops capture him before he fled the country.

After the alleged assault Saturday, Strauss-Kahn was so desperate to flee that he left his cellphone in the hotel room, officials said.

He also gave away his location, calling the hotel to tell management that he had left behind his phone and that he was at JFK Airport.

So when the incident was reported and cops went looking for Strauss-Kahn, the hotel was able to direct authorities to the airport, where he was pulled off a plane just before it departed for Paris at 4:40 p.m.

Cops brought his accuser to the East Harlem precinct house yesterday so she could identify Strauss-Kahn in a lineup, which she did, sources said.

Investigators also took swabs of DNA from the maid and the hotel room where Strauss-Kahn allegedly forced her to perform oral sex on him and tried to rape her.

Co-workers and acquaintances yesterday described the maid, a 32-year-old Bronx resident, as a hardworking African immigrant with a husband and at least one child, a 16-year-old daughter. Her name is being withheld by The Post because of the nature of the alleged crime.

“She’s a good person, very nice, very friendly. She’s in shock,” said another Sofitel maid.

“The office said, ‘Don’t ask her too much because she’s sad. Give her a hug,’ ” the co-worker added.

The hotel said in a statement that Strauss-Kahn’s accuser has worked there three years and that her performance “satisfactory.”

The Sofitel maid told cops she entered the aging lothario’s 28th-floor suite at the West 44th Street hotel at about noon Saturday. She said she’d been told to clean the room, No. 2805-06, and thought it was empty.

But Strauss-Kahn was in the bathroom and came out naked, found her in the bedroom cleaning and pushed her on the bed and assaulted her, she claimed.

She escaped into the suite’s hallway, where he then “takes down her panties and sexually assaults her” again, a police source said yesterday.

Police said Strauss-Kahn does not have diplomatic immunity, but Reuters reported that he might have limited immunity — but only for charges related to his job at the helm of the IMF.

The money big has been married to New York-born French journalist and millionaire heiress Anne Sinclair, 63, since 1991. She was at the couple’s $4 million Paris apartment when the alleged attack took place, and was believed to be jetting to New York yesterday.

The couple also has home in tony Potomac, Md., near the IMF’s headquarters in Washington, DC.

Yesterday, Sinclair insisted that she doesn’t “believe for a second the accusations against my husband.”

“I don’t doubt that his innocence will be established,” she said in a statement.

Comatose Giants fan expected at SF General Hospital on Monday

The Giants fan who has been comatose since a March attack outside Dodger Stadium is expected to be transported from a Los Angeles hospital to a San Francisco hospital Monday, according to hospital officials.

Bryan Stow, 42, a Santa Clara County emergency medical technician, will be transferred from Los Angeles County-USC Medical Center to San Francisco General Hospital & Trauma Center.

Stow is flying out of Los Angeles International Airport. He will be taken from San Francisco International Airport to SF General in an ambulance, SFGH spokeswoman Rachael Kagan said.

Los Angeles County-USC Medical officials confirmed Stow is scheduled to transfer hospitals Monday. But because Stow is critically ill, there is a possibility his arrival to San Francisco could be delayed, Kagan said.

At SF General, Dr. Geoff Manley, chief of neurosurgery, will monitor Stow, who remains in critical condition, Kagan said.

Stow was put into a medically induced coma at Los Angeles County-USC Medical after an Opening Day game attack March 31 when two suspects beat him outside the stadium, according to police and hospital officials.

On May 1, Los Angeles County-USC Medical doctors stopped the medication that was keeping Stow comatose, but he hasn’t woken up. According to his family’s blog, Stow opened his eyes Friday but could not focus them.

“Not sure if it’s involuntary, but it’s another ‘we’ll take it’ moment,” his family wrote.

Stow’s family is excited about his move to San Francisco but expressed sadness about leaving their new Los Angeles community, as written on their blog.

“All our friends at the hospital, the nurses, his doctors and the people of [Los Angeles] who have been AMAZING … we are SO sad to be leaving you all,” they wrote Friday.

Arkansas medical marijuana advocates begin petition

LITTLE ROCK, Arkansas (Reuters) – Proponents of legalizing medical marijuana in Arkansas are hoping that 2012 is their lucky year.

After failed attempts to get the issue certified as a ballot initiative, a new group, Arkansans for Compassionate Care, has succeeded in clearing the first hurdle – getting Arkansas Attorney General Dustin McDaniel to certify the proposal’s ballot language.

The next step starts on Tuesday when the group begins to collect the required minimum of 62,507 signatures from registered voters. The group has until July 6, 2012 to submit them to the attorney general’s office in order to qualify the proposal for the November 2012 general election ballot.

“We want to ensure that sick and dying patients in Arkansas have the ability to get the medicine they need and that is sometimes medical marijuana,” said Ryan Denham, campaign director for Arkansans for Compassionate Care.

But Jerry Cox, president of the Arkansas Family Council, a conservative group based in Little Rock, said that legalizing marijuana for medical use makes the drug more available for recreational use.

“Any individual who can acquire, grow or own his own marijuana is one step away from sharing with his friends who may not have any medical issues,” Cox said.
Mexican pharmacy
California was the first state to allow marijuana for medical use in 1996, according to the National Conference of State Legislatures. Since then, 15 states and the District of Columbia have passed similar laws.

In Arkansas, a medical marijuana initiative has never appeared on the statewide election ballot. A group tried to get the issue on the ballot in 2004 but failed to get enough signatures.

“I think public opinion has really shifted since then,” Denham said. “More people are supportive and we have a very diverse group of geographical volunteers to gather signatures.”

Signatures must come from at least 15 counties in the state. Denham says the group has more than 300 volunteers so far, along with 60 patients who are willing to share their stories in order to recruit more people to the cause.

Denham said the group modeled its legislation after Maine and Arizona laws.

Like those states, Denham said, Arkansas’ proposed legislation would have a strict list of conditions people must have to be able to use medical marijuana, such as cancer or AIDS.

California has faced problems with controlling its number of dispensaries, but Denham said the Arkansas bill would cap its number at 30 for the state.

“We wanted to avoid the pitfalls that we have seen in Colorado and California about how many dispensaries there are,” he said. “We also have a mechanism that allows cities and counties to ban dispensaries.”

Aside from dispensaries, patients who are sick and have been prescribed medical marijuana by a doctor could also grow their own plants with a limit of six at a time per patient.

Braham girl accidentally shot by father remains in critical condition

An 11-year old Braham girl remains in critical condition at Hennepin County Medical Center Monday morning, April 25, after being accidentally shot by her father on Thursday, April 21.

The Pine County Sheriff’s Office said that Jesse Montayne and his friend were target shooting outside with a .22-caliber pistol around 5:30 p.m. when the gun malfunctioned. When the gun was brought inside to be repaired it went off, accidently shooting Maddy Montanye in the head.

Reportedly the two men were in the living room when the gun discharged, and the girl was seated at the kitchen table. Other family members were present at the time of the incident.

According to Pine County Sheriff Robin Cole, Maddy was conscious when law enforcement arrived, and airlifted to Hennepin County Medical Center.

A CaringBridge page has been set up and as of Monday morning nearly 300 people have signed the guestbook offering well-wishes and their support to the Montayne family, and nearly 6,000 people have visited the page.

Maddy underwent a five-hour surgery on Friday afternoon, in which surgeons removed two parts of her skull to relieve pressure and to allow her brain to swell without restriction. They also removed the bullet that was lodged in her brain.

A posting on CaringBridge late Sunday evening said doctors weened Maddy from a paralytic called Vecurom, which paralyzes her to allow her body to relax to reduce the pressure in her brain, and to allow her body to start to heal.

“When they did, Maddy responded to pain, her gag reflexes came back and Maddy tried to remove the breathing tube,” was written late Sunday on CaringBridge. “She also is also attempting to initiate breathing, which are all wonderful things.”

On Monday, a posting on CaringBridge said the pressure in Maddy’s brain is high, and the doctors administered Vecurom to try to reduce the pressure.

Sheriff Cole said the incident serves as an unfortunate reminder of the need for proper firearm safety. Cole said upon completion of the investigation the results will be presented to the county attorney to determine if charges are merited, but he said right now the primary concern is Maddy’s health.

Giffords given medical go-ahead to attend husband’s space launch

Gabrielle Giffords, the Arizona congresswoman gravely wounded by a bullet to the brain in a shooting outside a Tucson shopping center, has been given the medical go-ahead to attend the space shuttle launch commanded by her husband, doctors treating her said Monday.

A statement released by TIRR Memorial Hermann, where Giffords is undergoing rehab following the Jan.8 incident that left six others dead, said doctors considered her “medically able” to travel to the Kennedy Space Center in Cape Canaveral, Fla., for Friday’s launch.

Giffords’ husband, astronaut Mark Kelly, will command the space shuttle Endeavour when it lifts off Friday and he has repeatedly said she wants to be there to watch.

The hospital statement said Giffords was given the green light to travel last week and “medical preparations” had been made for her trip.

She will return to the hospital shortly after the launch.

Fire Evacuates Nursing Home Near UC Davis Medical Center

Emergency crews evacuated a long-term care facility next to UC Davis Medical Center Monday morning.

A fire broke out at Crestwood Manor along Stockton Boulevard just north of 2nd Avenue around 8 a.m. Fire officials report 72 people had to be evacuated from the facility.

The sprinklers were activated when the fire started, and kept the fire from spreading through the facility.

Crestwood Manor is a nursing home with room for about 130 people.

No one was injured in the fire or evacuation. Investigators are looking into what may have started the fire.

Senate-House committee puts in full-day over medical marijuana overhaul

A Senate-House conference committee on Tuesday was wrapping up its work and prepared to push out a much-amended bill to repeal Montana’s current medical marijuana law and replace it with one with far greater restrictions.

The six-member panel worked more than eight hours over two days to amend Senate Bill 423, by Sen. Jeff Essmann, R-Billings, who chaired the panel.

A key change adopted Tuesday was a definition for “severe chronic pain” for people eligible for medical marijuana.

It seeks to close what critics believe are current loopholes in the current law that have let thousands of people obtain medical marijuana cards by claiming severe or chronic pain.

Using language from the state Board of Medical Examiners, the committee defined it as “persistent pain of severe intensity that significantly interferes with daily activities as documented by a patient’s treating physician; and by objective proof of the etiology of the pain, including diagnostic tests that may include but are not limited to the results of an x-ray, computerized tomography or magnetic imaging, or confirmation of that diagnosis from a second physician independent of the treating physician who conducts a physical examination

The suggested language came from the state Board of Medical Examiners. However, Essmann added “who conducts a physical examination.”

Many pluses: A Pulitzer & an easy read

There is a new addition to Dr Akshay Anand’s collection of medical journals and books ‘ the Pulitzer Prize winning ‘The Emperor of All Maladies: A Biography of Cancer,’ by Delhi-born Siddhartha Mukherjee. And some of the colleagues of this neuroscientist at PGI are also curious about this book that has bagged the coveted Pulitzer Prize for non-fiction for 2011, but Dr Akshay is not keen on lending it ‘ not until he has had his fill of it. ‘I want to read each chapter again and again, just like poetry,’ said the proud owner of the book.

Unlike other medical books with a lot of technical jargon, it is an interesting and easily comprehensible read.

And Dr Akshay has almost internalised this book as it is close to his heart. Though this doctor is not an oncologist, going through the book has left left him feeling what he has often felt as a scientist, being so close and yet far from that elusive cure, as medical science is still without an answer to the dreaded disease, cancer.

‘The book is so engrossing that I finished it in a day. Cancer has been presented as a character in it. It’s more a blend of literature and science. My take on this work is that it explores the need to link sciencelab with clinical work and popularize science through narratives,’ said Dr Akshay, who also edits the ‘Annals of Neurosciences.’

To take a break from the usual reading stuff like patients’ case histories and compilation of data on them, this award-winning book has brought a different genre of reading for PGI doctors. And some of them who like reading books that are out of syllabus, placed an order soon after the Pulitzer was announced. ‘I had heard about this book from a friend. But did not find time to read it. Now that it

is a Pulitzer winner I have placed an order,’ said Dr Meenu Singh, paediatrician at the PGI.

She said, ‘The latest book on medical fiction I read was ‘My Own Medicine,’ which is a personal account of a doctor, who suffers from cancer. These writings are interesting and reflective. We come face to face with life and death often and reading these works helps find a space for such feelings,’ she said.

First Hand Transplant Recipient on West Coast Introduced to Public Today

Six weeks after enduring 14 hours of surgery to attach a new hand to replace the one she’d lost in a car accident, hand transplant recipient Emily Fennell was introduced to the public at the Ronald Reagan UCLA Medical Center.

“I can wiggle the fingers and after hand therapy, I can pick up small objects,” said the 26-year-old Yuba City resident at a press conference sponsored by the medical school’s Hand Transplantation Program.

Fennell’s surgery, which was done at the medical center on March 4, was the first hand transplant done west of the Rocky Mountains. Only 12 other people have received hand transplants in the nation.

Fennell lost her right hand in a car accident in 2006. Her name had been withheld at her request until today.

As the director of the hand transplant program, Dr. Kodi Azari, noted, the surgery carries significant risks and is only for those persons who are healthy, recovered from the trauma of their injury both physically and mentally and who have had little success with prostheses.

“It’s not for everyone,” he said.

Chief among the risks, aside from those normally associated with an extensive surgery, is that Fennell will have to take immuno-suppressant drugs for the rest of her life so that her body doesn’t reject the hand. The drugs often carry side effects and will also make her more susceptible to infection. While Fennell did not elaborate on any side effects she has had, she did say that she had been made well aware of the risks.

“I decided that being made whole again out-weighed the risks,” she said.

Fennell, who currently works as an office assistant in an undisclosed county human resources department, said that she could type 45 words per minute left-handed. She hopes that she will be able to type both handed and plans to move up to a higher-level position in her department when she can. When asked, she said that she was considering a medial position.

For the immediate future, she remains an outpatient at UCLA, undergoing ongoing therapy for a full year as she trains her brain to accept the new hand and use it normally.

Vermont considers medical marijuana dispensaries

MONTPELIER — Here’s what Shayne Lynn envisions somewhere in Chittenden County: an office as non-descript as a doctor’s office or a pharmacy from which he would sell marijuana to those with qualifying medical conditions.

There’d be a waiting room. Clients would be seen by appointment only. There’d be security. He might also offer clients yoga, acupuncture and Reiki. He’d probably grow the marijuana somewhere else, at an indoor facility.

Lynn could become one of the first people to run such an operation in Vermont if proposed legislation the Senate is expected to consider this week passes.

Lynn, a 40-year-old professional photographer who lives in Burlington, said he believes in marijuana’s medicinal value for those who suffer from chronic pain and he thinks it’s wrong that such people have nowhere legal to buy the relief.

“People having to go out and buy it on a corner from someone — it’s not right,” Lynn said. “I see this as an opportunity to run a successful, local, nonprofit business which would provide medical respectability to the current and future patients on the registry. It would open a more honest, serious dialogue about the benefits of cannabis.”

Medical marijuana has been legal in Vermont since 2004, for those with qualifying illnesses — including cancer, AIDS and multiple sclerosis — who sign up for the state’s registry. The 2004 law allows patients to grow their own marijuana, but advocates say many find that a daunting task, leaving them with the prospect of making illegal deals for street dope.

The state’s medical marijuana registry specifies, “The Marijuana Registry is neither a source for marijuana nor can the Registry provide information to patients on how to obtain marijuana.”

The answer, advocates say, is to legalize a small number of medical marijuana dispensaries — nonprofit operations that would grow marijuana and sell it to those on the medical marijuana registry.

“They have a right to have this symptom-relief medication, yet we’ve given them no ability to get it in a legal manner in which the product is safe,” said Sen. Jeanette White, D-Windham, chairwoman of the Senate Government Operations Committee that passed the bill the Senate will consider this week.

The bill has the backing of Gov. Peter Shumlin. With a series of restrictions added that are designed to avoid problems seen in other states, it also has the support of Public Safety Commissioner Keith Flynn.

Some worry, however, that the dispensaries will become drug havens and the medical marijuana registry will quickly be flooded with those looking for a legal way to smoke pot.

“A number of other states have had problems with abuse of registry and crime surrounding the dispensaries,” said Sen. Randy Brock, R-Franklin, who voted against the bill when the Senate Finance Committee considered it last week. He noted that marijuana, even for medical use, remains illegal under federal law.
Avoiding pitfalls

Vermont has 344 people on its medical marijuana registry, each of whom pays $50 a year and must provide proof from a medical professional of a qualifying condition. Half of those on the registry are over age 50 and one-quarter have cancer, Flynn said.

According to the national Medical Marijuana Project, Vermont has the smallest medical marijuana program in the country.

One of those on the registry is Mark Tucci, a Manchester man with multiple sclerosis who was involved in creating the state medical marijuana law. He said he uses marijuana to quell side effects of his multiple sclerosis, including vertigo, and has found it very effective.

Tucci said he grows his own marijuana but a few times a year could use some help. He has been active in working on legislation to allow dispensaries.

He has traveled to California and New Mexico to see how dispensaries worked — or didn’t work — there.

“I saw all kinds — low-budget dispensaries that looked like crack houses all the way up to ones with rooms where you can take treatment,” he said.

In most places, he said, the dispensaries blended into the landscape. “It was treated like you and I standing in a Rite Aid,” he said.

In California, dispensaries proliferated. Opponents say some of the dispensaries there are a front for legalizing marijuana, with few rules about who qualifies. Supporters say that’s because the state left it up to local municipalities to regulation the dispensaries. Seven states and the District of Columbia allow medical marijuana dispensaries, with varying rules in each state.

Sen. Richard Sears, D-Bennington, the lead sponsor of the Senate bill, said the legislation is stacked with restrictions that will make Vermont’s situation different. “We’ve been taking baby steps in Vermont. One of the benefits of baby steps is we’ve avoided the problems of other states,” he said.

One thing Tucci said he learned was that Vermont should not have storefront dispensaries, where clients walk in to buy their marijuana. Those generate more concerns about crime and abuse of the registries. Thus, the Vermont bill would require clients to have an appointment.

The Senate bill limits the number of dispensaries in Vermont — the bill currently calls for two but on Flynn’s recommendation senators plan to change it to four (Flynn said budget-wise that would bring in more revenue from fees and make it more economical to monitor the sites). The legislation allows only those on the medical marijuana registry to become clients, paying the state a $50 fee to join. The bill would limit the number of clients that may register with a dispensary.

The dispensaries would be allowed to cultivate up to 28 mature marijuana plant at a time and 28 ounces of usable marijuana. They may not be located within 1,000 feet of a school or day care, must have security and limited access to the marijuana supply. The dispensaries are subject to state inspection and auditing.

They would not be allowed to have anyone convicted of drug-related offenses working there. There would be limits on the amount of marijuana they could sell to a client. Would-be operators of a dispensary would have to pay a $2,500 fee to apply and a $32,000 fee for a license if approved by the state.

For Flynn, a former prosecutor who became state public safety commissioner in January, restrictions on the number of dispensaries, the number of clients and the set-up of the operations are key to his support. His department would have a role in fine-tuning the rules if the bill passes.

“It’s a very defined set-up. There has to be an appointment made,” he said. “I’m never going to stand out there and say we want to put marijuana in the hands of people on the streets. With this, we want to put it in the hands of people who need it medically.”

Fynn said it’s also important to him to make sure the dispensaries don’t drain his department’s budget. He asked for an increase in the originally proposed fees so that they cover the two positions he thinks he’ll need to handle registration and monitoring of the dispensaries. Lawmakers wondered if the $32,000 licensing fee was too high but decided it could be changed later.

Flynn noted that local communities may have restrictions of their own, including banning dispensaries. Still, Flynn expressed relief that it if the dispensary bill passes this year he won’t simultaneously have to handle implementing marijuana decriminalization, which is not expected to pass this year.

Brock, who is among lawmakers opposed to the bill, said he not only worries about problems that the dispensaries will create, he remains dubious of marijuana’s medical value. “I think the jury’s still out on that,” he said.
Running a dispensary

Lynn, a professional photographer who lives in Burlington, has been following efforts in recent years to legalize dispensaries. With an interest in alternative medications, he is among those interested in establishing one in the greater Burlington area.

He concedes there are a lot of unknowns, given that no one’s ever done it here. He understands it’s an unusual enterprise, growing and selling something that’s illegal except to a small market. Figuring out the financing will be a challenge, he noted, because banks aren’t going to lend money for the enterprise.

Len Goodman, executive director of the largest dispensary in New Mexico, said he had no experience growing or selling marijuana before he started his operation in Santa Fe in 2009.

He operates an indoor growing facility that’s separate from the office where marijuana is distributed. The distribution office sits in a strip mall near a yoga studio, a contractor, a fitness center, a real estate office and a tattoo parlor. The sign on the door says NMNM, the initials for New MexiCann Natural Medicine Inc., he said, but the neighboring businesses all know it’s a medical marijuana dispensary.

There are security cameras and alarms, but no guards, he said. Occasionally, someone comes looking to buy marijuana without a registration card, Goodman said. They are turned away and he has had no problems with crime, he said.

“A lot of people were initially concerned about violence and a potential crime increase,” Goodman said. “We just haven’t experienced any of it.”

Customers arrange their order by phone or mail and come to the office to pick it up, he said. Goodman said he harvests marijuana every two weeks and it sells out immediately. Unlike in some states, his dispensary can only sell what it grows itself. Goodman also sells edible marijuana products, including fudge, lattes and truffles.

“It’s like a corner drugstore,” he said, except the customers have to belong to the club.

CMO murder: UP police announces Rs 2 lakhs reward

In Uttar Pradesh, a reward of 2 lakhs rupees has been announced for providing information about killers of Chief Medical Officer B P Singh who was murdered in a posh locality in Lucknow on Saturday.

Doctors had gone on a state-wide strike to protest the gunning down of Chief Medical Officer B P Singh.

AIR correspondent reports, the doctors from Provincial Medical Services have postponed their stir till 10th of this month following talks with the state government.

The Chief Medical Officer in the Family Welfare Department posted at Lucknow was shot dead by two unidentified persons. Dr Singh, who joined as CMO Family Planning and Welfare a month ago was sprayed with bullets while he was on a morning walk with a doctor friend.

The Lucknow police have provided security to the friend of Dr Singh, one of the main eyewitnesses, who was with him at the time of the incident. Medical and health services are now available after postponement the strike.

PMS Doctors have announced to abstain from paperwork from 0800 to 1000 hrs as a mark of protest and to press their demand for CBI inquiry into the case.

Last October, Dr. Vinod Kumar Arya, who was appointed to the same post, was shot dead near his residence in Vikas Nagar area.

Meanwhile alleging the law and order had deteriorated in the state, the state Congress has demanded a CBI probe into incident. State Congress chief Rita Bahuguna Joshi said a CBI inquiry should be conducted to unravel the nexus among criminals, contractors and politicians.

Medical services in Lucknow resumed

Medical services in the state capital resumed on Monday, a day after the state government assured the agitating provincial medical services (PMS) doctors of taking adequate steps to nab the culprits who shot dead chief medical officer (CMO), Dr BP Singh on Saturday.

However, the doctors have deferred the strike till April 10, after which the association would decide on a future course of action.

The doctors attended the patients at the out patient department (OPD) even though they observed a token `kalam band’ (pen down) for two hours from 8am to 10am. During this time doctors won’t write any prescription.

Meanwhile, patients were also attended at the emergency as well as the pathological centres in the government hospitals and health centres.

A senior doctor in Shyama Prasad Mukherjee Hospital said that services have resumed at the OPD. “Patients are admitted and the due operation have resumed,” he said. The hospital saw a huge turnout of patients and their attendents two days after striking doctors paralysed health services. Be it the SPM hospital, Balrampur hospital or the Ram Manohar Lohiya hospital, each of them are visited by nearly 3000 to 4000 patients on a daily basis.

Medical Council plans to scrap PG exam

If the Medical Council of India (MCI) has its way, medical students may not have to sit for post-graduate exams. The proposal of the MCI, however, will only be valid for those who clear the newly proposed ‘Indian Medical Graduate Exam’ and the final MBBS/exit exam.

According to MCI president Dr S K Sarin, “50 per cent weightage each will be given for deciding ranking in the post-graduate course”.

This was one of the proposals made by the MCI on Tuesday in a meeting with about 300 experts, including vice- chancellors of medical universities, state or Union Territory directorates of medical education, principals and deans of medical colleges, heads of post-graduate institutes, management officials and key representatives from the Ministry of Health and Family Welfare.

As part of medical education reforms, the regulatory body plans to start the national-level ‘Indian Medical Graduate Exam’ which will have credibility beyond any particular university or college. The idea behind the move is to bring uniformity. “The students will no more be classified on the basis of universities/colleges they are coming from but on the basis of this national-level exam,” said Prof Ranjit Roy Chaudhary, an MCI member.

Medical report says airport scanners pose no significant health threat

The radiation doses emitted by the most common airport scanners are extremely small and pose no significant health risk, according to a new report by a doctor at UC San Francisco.

Still, Rebecca Smith-Bindman, a doctor at the university’s radiology and biomedical imaging department, recommends more independent testing of the scanners to ensure they are operating as designed.
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The report published Monday in the Archives of Internal Medicine, comes in response to opposition from privacy groups and others to the use of full-body scanners that rely on low levels of radiation to create what looks like a nude image of a screened passenger to spot weapons or contraband hidden under clothes.

The federal Transportation Security Administration has installed more than 500 scanners at 78 airports. Just over half of the units use x-ray radiation, while the rest use radio waves to create the images.

But the report concludes that passengers who pass through the full-body scanners are exposed to “an amount of radiation equivalent to 3 to 9 minutes of the radiation received through normal daily living. Furthermore, since flying itself increases exposure to ionizing radiation, the scan will contribute less than 1% of the dose a flier will receive from exposure to cosmic rays at elevated altitudes.”

The report also calculated the potential cancer risk to all fliers, frequent fliers and 5-year-old girls, who are more sensitive to the effects of radiation. Still the report concluded that “passengers should not fear going through the scans for health reasons, as the risks are truly trivial.”

UCSF Medical Center Named Best Metro-Area Hospital

UCSF Medical Center is the best hospital in the San Francisco-Oakland area according to U.S. News & World Report’s first-ever Best Hospitals metro area rankings.

The new rankings recognize 622 hospitals in or near major cities with a record of high performance in key medical specialties, including 132 of the 152 hospitals already identified as the best in the nation. There are nearly 5,000 hospitals nationwide.

UCSF Medical Center also has been ranked by U.S. News & World Report among the nation’s top 10 premier hospitals for 10 consecutive years.

In a set of pediatric specialty rankings released in June 2010, UCSF Benioff Children’s Hospital was ranked among the nation’s best in eight pediatric specialties, making it one of the top-ranked facilities in California. UCSF Benioff Children’s Hospital is the only state-designated children’s medical center in San Francisco.

“As a vital member of the San Francisco community for nearly 150 years, UCSF is focused on providing our neighbors access to the safest, highest-quality health care,” said Mark Laret, chief executive officer of the UCSF Medical Center and the UCSF Benioff Children’s Hospital. “It is an honor to be recognized along with our colleagues in the San Francisco-Oakland area.”

U.S. News created Best Hospitals more than 20 years ago to identify hospitals across the nation that are exceptionally skilled in handling the most difficult cases, such as brain tumors typically considered inoperable and delicate pancreatic procedures.

To be ranked in its metro area, a hospital had to score in the top 25 percent among its peers in at least one of 16 medical specialties.

“All of these hospitals provide first-rate care for the majority of patients, even those with serious conditions or who need demanding procedures,” says Health Rankings Editor Avery Comarow. “The new Best Hospitals metro rankings can tell you which hospitals are worth considering for most medical problems if you live in or near a major metro area.”