Health

Most people are unaware that the condition of their teeth can affect the health of their entire bodies. Dentist Charles Martin has published a book focusing on his research which shows that oral health is related to a huge range of health issues:

“My theory, based on years of study and direct observation of my dental patients, is that proper dental care can help patients cut their risk of diabetes, heart disease, stroke, kidney disease, cancer or having low birth-weight babies. It can also have a positive effect on patients with ulcers, sleep apnea and obesity,” Dr. Martin explained. “Many of the diseases linked to periodontitis are also diseases that require behavioral changes if people want to live the healthiest, most enjoyable lives possible. To make those changes, they must understand the risks they face by not taking action. Gum disease, tooth decay, bleeding gums and poor dental health aren’t just about the mouth anymore. These affect your whole body, your energy levels, how good you feel and how long you live.”

More details can be found in the full article. To learn more about how you can speak up for oral health, please visit www.hcfama.org/oralhealth.
-Christine Keeves

The New York Times recently published a disturbing article about children with significant mental health needs who were dramatically overmedicated by physicians.

To be clear: the Children’s Mental Health Campaign does not support over-medicating children. No one believes the solution to mental health issues is creating obese, zombie-like children who are at risk of serious medical conditions like diabetes. The Campaign strongly believes in appropriate treatment to address the specific mental health needs of young people.

It is perhaps too easy to conclude from the stories in this article that medication is never the answer for children struggling with mental illness. Such a stance, however, ignores the experiences of literally thousands of families across the country – including many here in Massachusetts. The fact is that medication is often very helpful in addressing the mental health needs of children. That’s not me talking – it reflects the comments of parents in responding to inquiries by the Parent/Professional Advocacy League, a state-wide organization of parents of children with mental health needs.

In June 2008, PAL released a report (pdf) on the attitudes toward and experiences with mental health medications by families impacted by mental illness. Interestingly, PAL found that one of the most effective tools that parents found for addressing the mental health needs of their children was medication.

For families of children with mental health needs, all options should be available to them. It would be a mistake to demonize medication. While clearly medications should be used judiciously, treating mental illness is too important to take a tool that works off the table.
-Matt Noyes

The Institute for Healthcare Improvement offers free one-hour audio and on-line learning opportunities every other week through its WIHI program. The September 9th featured speaker is Maureen Bisognano, the new President and CEO of IHI following the departure of Don Berwick to be the Administrator of the Centers for Medicare & Medicaid Services (CMS). In this interview-style session, learn more about where she sees health care and the work of IHI going under health reform and efforts to revamp payment and care delivery systems. Register and learn more about this program and other upcoming WIHI programs on the WIHI section of the IHI website.
-Deborah W. Wachenheim

The Washington Post: "Amid high unemployment and a weak economy, employers have been shifting health care costs to workers, according to a study released Thursday. The premiums that employees pay for employer-sponsored family coverage rose an average of 13.7 percent this year, while the amount that employers contribute fell by 0.9 percent, the survey found. For family coverage, workers are paying an average of $3,997, up $482 from last year, while employers are paying an average of $9,773, down $87, according to the survey by the Kaiser Family Foundation and the Health Research & Educational Trust" (Hilzenrath, 9/2).

Kaiser Health News: Thirty percent of employers reported reducing the health benefits they offered or increasing the employees' share of the cost. Paul Fronstin, senior research associate with the Employee Benefit Research Institute, a nonprofit, nonpartisan organization, said employers increase workers' share of premiums only if they are desperate -- because it can drive the healthiest employees to drop coverage, resulting in higher premiums for everyone else. 'Raising the employees' share of the premium really makes no sense,' he said. Yet, it's likely to keep happening. A survey released in August by the National Business Group on Health, an employer coalition, found 63 percent of large employers planned to increase the proportion that employees contribute to their premiums next year" (Galewitz, 9/2).  (KHN is a program of the foundation.)

Bloomberg: "Total premiums for family policies, including both worker and employer contributions, increased 3 percent to $13,770" (9/2). 

The Associated Press: "Researchers found that businesses still pay at least 70 percent of the total premium, on average, for their workers ... A growing percentage of workers are covered by health insurance that requires them to pay a deductible of $1,000 or more before most coverage starts. The increase is most striking with smaller companies, where 46 percent of workers are enrolled in high-deductible plans, up from 16 percent in 2006. At companies with 200 or more employees, 17 percent of covered workers had high-deductible plans, up from 6 percent four years ago" (Murphy, 9/2).

CNN: "Over the past five years, employees' share of insurance premiums have risen 47%. That has outpaced a 27% jump in overall premiums and an 18% increase in wages, according to Kaiser. Deborah Chollet, senior fellow and health economist with Washington-based Mathematica Policy Research, said the recession and a turbulent job market are key catalysts for rising insurance costs. 'Employers are struggling to keep their head above water. They're cutting costs just to maintain employment,' Chollet said. 'One way to do that is to make workers pay more'" (Kavilanz, 9/2).

The New York Times: "'From a consumer perspective, the cost of health insurance just keeps going up faster than wages,' said Drew Altman, Kaiser’s chief executive, in a news release" (Abelson, 9/2).

NPR: "Altman says the upward creep of all sorts of health costs for employees, including deductibles and copayments, raises a more ominous question about affordability of health care for the majority of Americans who still get their insurance on the job. 'While we were all focused on expanding coverage in the health reform debate, I think what we missed is that while that debate was going on, what we call health insurance in the country has actually been changing an awful lot,' he said. 'So what most people get as health insurance today just doesn't look very much like the more comprehensive health insurance their parents got'" (Rovner, 9/2).

News outlets are reporting that some states and businesses who oppose parts or all of the health reform law are applying for the financial relief it provides.  

The Hill: "About two dozen businesses associated with high-profile opposition to the healthcare reform law are taking advantage of a provision that helps pay for their retirees' medical bills, according to a review of federal records by The Hill." For instance, Koch Industries in Kansas - whose owners, David and Charles Koch, opposed the law and help bankroll the Tea Party movement - is applying for the early retirees' subsidy. Also, "more than a dozen members of the board of directors of the U.S. Chamber of Commerce have also been accepted into the program. The Chamber has been a leading foe of the law" (Pecquet, 9/1).

The Fort Worth Star Telegram: Four Texas cities and 90 other employers have applied and been accepted to receive portions of the money "though Texas is among the states suing the federal government over the constitutionality of the healthcare reform law." One official said, "Anytime we can get additional funding to help lower our costs, it is a good thing. The city of North Richland Hills has a self-insurance fund for both employee and retiree health insurance coverage. Any reimbursements North Richland Hills gets through this program will go back into the self-insurance fund" (Tinsley, 9/1).

Fairbanks Daily News-Miner: The state of Alaska, which is part of a suit to overturn part of the health law, is also an approved recipient of the early retirees' funding. "In announcing that he was joining the lawsuit, Gov. Sean Parnell said in April that the 'federal government has reached well beyond the score of its authority— into the lives and freedom of Alaskans'" (Cole, 9/2).

Meanwhile, the state of Nebraska is pursuing a $1 million grant to help set up a health insurance exchange as part of the overhaul, the Omaha World-Herald reports that Nebraska "Gov. Dave Heineman once again mixed politics with pragmatism about the federal health care overhaul Wednesday, while education leaders wrestled over taking a stand on the law. Heineman blasted the law in a letter urging a group of state senators to call for its repeal. In now-familiar language, he said the law 'raises taxes on Nebraskans, cuts Medicare and causes health insurance premiums to increase.' But the governor also announced that Nebraska is seeking a $1 million federal grant to plan for a health insurance exchange" (Stoddard, 9/2).

A new Commonwealth Fund report estimates that "about 16.6 million workers are employed by small businesses that are eligible for health insurance tax credits" under the new health law but only 3.4 million of them are at companies that will take advantage of the credits, The Washington Post reports, adding that those businesses already offer their employees health insurance. "Those firms that do not offer coverage are unlikely to consider the tax breaks enough of a financial incentive to start doing so, according to the report's authors. Still, the authors stressed the potential stimulus benefits of the tax credits, which apply beginning this taxable year and will increase in value in 2014 from as much as 35 percent of an employer's premium contribution to as much as 50 percent" (Aizenman, 9/2).

The Baltimore Sun: "Coverage provided from such firms has eroded over the last decade. While 98 percent of companies with 200 or more employees offer health insurance, only 46 percent of companies with fewer than 10 employees do. ...  The report notes that the Congressional Budget Office estimates that small businesses could get $40 billion in credits in the next decade and reduce the premiums they pay 8 to 11 percent by 2016" (Cohn, 9/2).

Modern Healthcare: The credit expires in 2016. "'It is really an economic stimulus measure that will help small businesses get through these tough economic times,' said Karen Davis, president of the Commonwealth Fund" (Vesely, 9/2).

Los Angeles Times: In the meantime, a Rand Corp. simulation estimates the number of workers who have access to health care through their jobs will increase from around 84 percent to nearly 95 percent, once health insurance exchanges are up and running. "Most of that bump is likely to come from smaller businesses with 50 or fewer employees. Today, only 60.4% of these employees can get health insurance through their jobs. Once the exchanges are functioning, the Rand researchers forecast that 85.9% of small business employees will have the option of buying health plans at work – an increase of 10.5 million workers" (Kaplan, 9/1).

An insurance exchange has recently opened to businesses with fewer than 50 employees in Utah, the Deseret News reports. "Rather than have one or two options that are pre-selected by their employers, workers can choose from more than 60 different plans from four of Utah's largest insurance companies: Humana, Regence, Select Health and United Healthcare. By state statute, all plans offered through the Utah Health Exchange must meet federal standards for employer-sponsored coverage, which ensures all plans offered provide quality coverage from responsible carriers. It is also expected that the element of consumer choice — employees selecting their plans directly from carriers — will put downward pressure on prices and upward pressure on coverage quality" (Leonard, 9/1).

Kaiser Health News staff writer Phil Galewitz reports: "Workers nationwide, on average, are paying nearly $4,000 toward the cost of family coverage. That's a hefty 14 percent, or $482, more for family health insurance in 2010 than in 2009, according to a survey released today by the Kaiser Family Foundation (KHN is a part of the foundation) and the Health Research & Educational Trust, two nonprofit organizations that focus on health policy issues (Galewitz, 9/2). Read the entire story.

The day after President's Day this year, employees of the President Abraham Lincoln Hotel and Conference Center in Springfield, Ill., got bad news: The hotel would no longer help pay for health insurance coverage for workers' spouses and children.  It had been covering 60 percent of the cost.

Brian Lewis, a front desk clerk, saw his monthly health insurance premium jump to $460 from $230 to cover himself and his wife, Sarah. He estimates about a third of his paycheck now goes to health coverage. "We try to live a little more modestly," said Lewis, 28. "We used to go out of town for a few weekends, but not anymore."

Related Charts

Average Annual Health Insurance Premium Costs

Average Amount Workers Contribute To Health Insurance

SOURCE: Kaiser Family Foundation/HRET Survey of Employer-Sponsored Health Benefits, 1999-2010.

In facing rising costs for coverage, Lewis isn't unusual. Workers nationwide, on average, are paying nearly $4,000 a year toward the cost of family coverage. That's a hefty 14 percent, or $482, more for family health insurance in 2010 than in 2009, according to a survey released today by the Kaiser Family Foundation and the Health Research & Educational Trust, two nonprofit organizations that focus on health policy issues. (Kaiser Health News is a part of the foundation.)

Total premiums for family coverage, taking into account both employee and employer contributions, are $13,770, up 3 percent from last year, the survey found.

The share of the premium paid by workers jumped 3 percentage points to 30 percent. In the dozen years the survey has been conducted, the employee share of family coverage has never topped 28 percent and has never risen more than 2 percentage points in a single year.

In past years, employers typically have shared the increase in health costs with workers. This year, employers' contribution to the premium remained flat on average, the survey said.

Drew Altman, president and CEO of the Kaiser Family Foundation, said in an interview that "shifting the costs to workers during a terrible economy is bad news for working people." He added, "It speaks to the depths of the recession and the pressure employers are under, and it means added economic insecurity for working people."

Thirty percent of employers reported reducing the health benefits they offered or increasing the employees' share of the cost.

Paul Fronstin, senior research associate with the Employee Benefit Research Institute, a nonprofit, nonpartisan organization, said employers increase workers' share of premiums only if they are desperate -- because it can drive the healthiest employees to drop coverage, resulting in higher premiums for everyone else. "Raising the employees' share of the premium really makes no sense," he said.

Yet, it's likely to keep happening. A survey released in August by the National Business Group on Health, an employer coalition, found 63 percent of large employers planned to increase the proportion that employees contribute to their premiums next year. The survey was based on responses from 72 of the nation's largest employers representing more than 3.7 million employees.

"This is a growing reflection that costs are unaffordable and the general state of the economy," said Helen Darling, president of the group. She said most employers increasing the employee share of health premium were charging workers only a small part of the costs. She said the trend could lead employees not to cover their dependents.

At the Lincoln Hotel, nearly all the employees who had been covering spouses and children stopped covering their dependents when the hotel decided to no longer help pay the cost. The hotel still covers about 60 percent of health insurance premium for its 140 employees.
 
Jeanne Miller, human resources coordinator at the 316-room hotel, said the hotel made the switch as a result of less business from conferences. "People panicked … it was rough," she said of employees' reaction.

She said the business increased the employee share even though the total premium only went up slightly. "It was all about cutting costs," Miller said. The hotel, which bills itself as the closest hotel to the Abraham Lincoln Presidential Library and Museum, this summer did not follow its usual practice of offering pay raises to workers.

Lewis said the he had little choice but to pay the higher rate because his wife has asthma and a thyroid condition and takes medication for both. They hope to save money next year when his wife will switch to a plan provided by her own employer, a local insurance agency.

Nationally, employees now pay an average of $3,997 as their share of the annual family health insurance premium — about $1,000 more than in 2006 and twice the 2001 amount, the Kaiser survey found. For single coverage, employees this year pay an average of $899 -- nearly triple the price of a decade ago.

The increase in health costs in recent years has far outstripped inflation and helped propel efforts to overhaul the country's health system. Since 2005, premiums overall have gone up 27 percent, more than twice the rate of inflation. In that period, workers' contributions to premiums rose 47 percent. Wages since 2005 have increased 18 percent.

The Kaiser survey, completed by 2,046 employers, was conducted between January and May of 2010.

The new health law, which will expand health coverage to 32 million Americans starting in 2014, will bring no immediate cost relief for most workers getting coverage in the workplace.

Under the health overhaul law, employees who have to spend more than about 9.5 percent of their income buying health coverage through an employer will be able to buy lower cost coverage in new insurance exchanges, or marketplaces. But that benefit won’t start until 2014.

Most of the major provisions in the law that aim at reducing health costs— such as pilot projects that bundle Medicare costs to hospitals and doctors -- will take years to play out and results are anything buy certain.

"The new law helps a lot of people in a lot of ways … but in general it left employer-based coverage alone," Altman said. "That is what the politics of health care dictated and what the American people asked for."

But as the Kaiser survey shows, employer-based coverage is anything but stagnant as workers face more financial barriers to access care. About 27 percent of employees now face annual deductibles of at least $1,000, up from 22 percent in 2009 and 12 percent in 2007, the survey showed.

J.W. Cheatham LLC, a construction company in West Palm Beach, Fla., used to pay the full cost of employees health insurance premium. But when the economy worsened two years ago, it started charging employees about $26 a week. Although the employees' share of the premium may seem modest, it was still too high for 10 of the company's 96 employees who chose to drop the coverage.

Those employees are all uninsured, said Michael Damron, co-owner and personnel director at Cheatham.

The company initially faced a 9 percent increase in health premium costs this year, but it negotiated that down to 4 percent after agreeing to bundle the purchase of health and life insurance through Blue Cross and Blue Shield of Florida. In addition, the company eliminated paid vacation and holidays for employees this year. Those cost cutting measures helped Cheatham hold the line on premium costs for workers. Employees are paying $26.80 a week.

Damron is already worrying about how much higher insurance costs will go to next year.   "It never goes down."

 

 

Debunking Medicare Myths Kaiser Health News
What's needed most today in American health care is innovative change which drives up productivity and value. With the right incentives, that's what the private sector can deliver, even as it's been clear for some time that the federal government cannot do likewise (James Capretta, 9/2).

The Effects Of The Affordable Care Act On Workers' Health Insurance Coverage New England Journal Of Medicine
Many employers will find that offering coverage through the exchanges is an attractive option, owing to wider risk pooling, low administrative costs, and expanded choices (Christine Eibner, Peter Hussey and Federico Girosi, 9/1).

Health Care 'No' Hurts Minnesota (Minneapolis-St. Paul) Star Tribune
How much federal money will Minnesota lose to other states because Gov. Tim Pawlenty dislikes the new federal health care reform law? ... The lost-opportunity tally is bound to grow — and with it, the negative impact on Minnesota lives (9/1).

Court Pulls Plug On Bad Amendments (Fort Myers, Fla.) News-Press
Legislating by referendum is usually a bad idea, in part because it's tough to deal with complex issues in ballot language that's simple and clear enough for voters to understand. The process also lends itself to trickery. The Florida Supreme Court is to be applauded for stepping in this week to prevent both kinds of abuse on the November ballot (9/2).

Patients Are Less Likely To Sue When Doctors Apologize For Errors St. Louis Post-Dispatch
But we don't have to choose between fairly compensating injured patients and protecting good doctors. The key to reducing malpractice claims dramatically lies with doctors and hospital administrators (9/1).

The Associated Press: "Allergan Inc., the maker of wrinkle-smoothing Botox, has agreed to pay $600 million to settle a yearslong federal investigation into its marketing of the top-selling, botulin-based drug. The Justice Department and the company said Wednesday in a statement it will plead guilty to one misdemeanor charge of 'misbranding,' in which the company's marketing led physicians to use Botox for unapproved uses. Those included the treatment of headache, pain, spasticity and cerebral palsy in children. Companies are prohibited from promoting drugs for unapproved, or 'off-label,' uses. Allergan said it will pay $375 million in connection with the plea, which includes the forfeiture of $25 million in assets. Additionally, the company will pay $225 million in civil fines — $210 million to the federal governments and the rest to several states — related to the investigation, although the company denies liability for the civil claims" (Perone, 9/1).

CBS News: "While drug maker Allergan has pled guilty to illegally marketing its drug Botox for unapproved uses such as migraines, CBS News has learned that the manufacturer has been busy testing the drug overseas for the same ailments. … Allergan is recruiting patients and running these trials in countries such as India, Poland, Russia, Egypt, Lebanon, Turkey and Serbia" (Strickler, 9/1).

Reuters: "The U.S. Department of Justice will continue to 'aggressively pursue' pharmaceutical companies that illegally market drugs for uses that have not been approved by health regulators, a top agency official said on Wednesday" (Pelofsky, 9/1).

San Francisco Chronicle: "A report released Wednesday found foreclosures have not only economic consequences, but create health problems for the people and families involved -- and those effects can ripple throughout a community. In a survey of nearly 400 residents in two Oakland neighborhoods particularly hard hit by the foreclosure crisis, the Alameda County Public Health Department and Causa Justa/Just Cause, a housing rights group, teamed up to look at how people undergoing foreclosure experience higher levels of stress and increased medical" (Colliver, 9/2).

The Associated Press/Bloomberg Businessweek: "Supporters of an expanded smoking ban said Tuesday the proposed [South Dakota] state measure will protect workers and reduce health care costs stemming from cancer, heart attacks and respiratory disease. A state law in effect since 2002 bans smoking in most workplaces and public areas. The expanded measure, Referred Law 12 on the November ballot, would extend the ban to bars, video lottery establishments and Deadwood casinos. Evidence shows a link between secondhand smoke and certain health problems, said Dr. Karla Murphy, president-elect of the South Dakota State Medical Association" (Ortman, 9/1).

The Associated Press/Seattle Times: "A new state program that offers health insurance to small businesses has begun signing up members. It's called the Health Insurance Partnership. Enrollment started Wednesday and coverage will begin next year. Companies with 50 or fewer employees are eligible" (9/1).

The Oklahoman: "The state's Employees Benefits Council on Wednesday approved revised rates for HMO health insurance plans available to state employees and their families. The revisions came after the state Supreme Court last week ruled legislation passed earlier this year creating a 1 percent fee on insurance claims paid by providers was unconstitutional. ... For 2011, state employees and their families may choose health coverage from three HMO providers: CommunityCare, GlobalHealth and PacifiCare. Employees may also choose HealthChoice, the state-run, self-insured indemnity plan" (9/2).

The Associated Press: "Supporters of a voter initiative that could help bring cheaper prescription drugs to North Dakota are hoping a legal technicality won't keep them from getting the issue placed on the ballot. At issue is a state law that requires most pharmacies to have a pharmacist as their majority owner. Those who want it repealed say the change will allow large retailers such as Wal-Mart Stores Inc. and Walgreen Co. to sell cheaper prescription drugs from their own store pharmacies. Opponents fear the measure could drive rural pharmacies out of business. North Dakota is the only state in the nation with such a law, according to industry officials. It's not certain whether the voter initiative will land on the ballot" (Wetzel, 9/1).

Chicago Tribune: "Target Corp., renewing its push into retail medicine, will open eight new clinics in the Chicago area and Palm Beach, Fla., giving a boost to a form of health care delivery that has seen slower growth amid the economic downturn. The Minneapolis-based retail giant launched its first health clinic four years ago but has not been as aggressive as rivals CVS/Caremark Corp. and Walgreen Co., which have opened several hundred clinics in recent years. ... [Clinics] treat patients for routine illnesses and injuries such as ear and sinus infections, skin treatments and certain vaccinations. The model has been greeted by health insurers, employers and consumer groups as a convenient way to address the rising cost of health care. Retail clinics, which are generally staffed by nurse practitioners, typically are less expensive than a trip to a physician's office, which can cost an employer or insurer $100 or more" (Japsen, 9/1).

MarketWatch: More warnings about credit cards - including those to pay for health care services - are coming from New York's elected officials. Sen. Charles Schumer sent a letter to the Federal Reserve noting a 256 percent leap in solicitations to consumers for professional and business credit cards. Schumer raises these concerns "on the heels of New York Attorney General Andrew Cuomo's launch of an industry-wide probe into predatory lending in the health-care realm. ... A health-care credit card allows you to charge procedures and treatments that your insurance company doesn't cover, such as chiropractic, cosmetic and dental procedures, infertility treatments and even veterinary services for Fluffy" (Waters, 9/2).

Earlier, related KHN story: Regulators Probe Allegations Of Fraud In Health Credit Cards (Andrews, 8/31)

Democrats are likely to again push to give billions in health coverage assistance to Ground Zero workers when they return from their recess, Roll Call reports. "A Democratic leadership aide said Tuesday that the bill likely would get the green light for floor action shortly after the House returns Sept. 14 in conjunction with events planned to commemorate the ninth anniversary of the Sept. 11 terrorist attacks." The bill failed to get a 2/3 majority in the House in late July and "touched off a heated exchange on the House floor between New York Reps. Anthony Weiner (D) and Peter King (R) over which party was to blame" (Hunter, 9/1).

The White House, in the meantime, is saying no to lawmakers who want the administration to announce the first round winners in the bidding process to provide durable medical equipment to Medicare, The Hill reports. More than 130 House members had asked the Centers for Medicare and Medicaid Services to release the list. "'Without knowing the identity as well as the appropriate overall qualifications of these providers, we cannot evaluate the program's impact in terms of quality and access to care for seniors we represent,' the lawmakers wrote in an Aug. 11 letter to [CMS administrator Don] Berwick. … CMS has said it will announce the contract winners later in September, 'once all contracts have been finalized.'" The bidding process is meant to control costs and lower fraud in the DME industry (Lillis, 9/1).

The recent salmonella outbreak/egg recall is raising questions about whether the FDA is fulfilling its regulatory role, PBS' NewsHour reports. "For the past few years, it's been one food safety scare after another. There was E. coli-laced spinach, salmonella-tainted peppers. ... There have also been problems with drugs. The ingredients in a contaminated blood thinner came from China. And whether the tainted products are from abroad or the United States, it's the Food and Drug Administration's job to make sure they're safe for American consumption. The FDA has received some new money from Congress to police food and drugs, $141.9 million last fiscal year alone just for food safety."

Margaret Hamburg, commissioner of the FDA, however, says the agency lacks the necessary resources to do its job. Online pharmacies present a particular challenge. "While there have been very few reported cases of people becoming sick or dying from taking unapproved or counterfeit drugs, the FDA is concerned because the trade is growing so fast" (Bowser, 9/1).

Meanwhile, The Wall Street Journal reports on a doctor in Belgium who, after drug companies were unwilling to help fund clinical trials for a possible treatment, began injecting himself with a vaccine previously tested only on dogs and rats. "The reason for this desperate measure: Dr. [Stephane] Huberty suffers from myasthenia gravis, a rare neurological condition. It is one of more than 5,000 'orphan' diseases, so called because there are so few sufferers that most pharmaceutical companies are reluctant to invest in cures. ... Taking unapproved drugs is also the last resort for thousands of patients who are desperate to get access to new biological, stem-cell and vaccine technologies that are being invented much faster than regulators can certify them." The FDA  "oversees a laborious approval process that requires drug developers to conduct four phases of trials, involving thousands of patients. It can take as long as 10 years to get a drug approved." Self-treatment by doctors has a long and sometimes-checkered past (Miller, 9/2).

In his latest Kaiser Health News column, James Capretta writes: "Here's a puzzle: Critics say Medicare Advantage plans -- the private insurance options offered to beneficiaries -- are inefficient and costly. But those same critics oppose vouchers for Medicare -- even though that would set up a direct competition between the private plans and the traditional fee-for-service program. What are they afraid of?" (9/2). Read the entire column.

The growth rate of health spending is at its slowest in a half-century, "a sign that people are forgoing medical care during the recession," according to an "analysis of government data" by USA Today.

"Spending on doctors, hospitals, drugs and other medical care climbed at a 2.7% annual rate per person in the first half of 2010, the smallest increase since the Bureau of Economic Analysis began tracking medical care in 1959. When inflation is taken into account, spending per person actually fell 0.2% in the first six months of the year. That's the first decline since the government began adjusting for inflation in 1995… [The drop] appears to be the result of a bad economy and high unemployment, health care experts say. ... The recession has shifted some people from private insurance to government programs, says health care economist Robert Brook of the conservative Heritage Foundation. That may have cut overall spending because the government generally pays lower rates than private insurers, he says" (Cauchon, 9/2).

The Wall Street Journal: "The two scientists behind the lawsuit that has temporarily blocked federal funding for embryonic stem-cell research said Wednesday they were motivated by ethical objections to destroying human embryos for medical research. The scientists, James Sherley of Boston and Theresa Deisher of Seattle, had never met until this week, when they flew to Washington to confer with House and Senate aides and lobby against research using embryonic stem cells. They were recruited separately by lawyers looking to challenge the federal policy. … A federal judge last week ruled the research violated federal law. The decision rocked the scientific community while bolstering social conservatives, who have long argued the experiments are immoral" (Meckler and Adamy, 9/2).

U.S. News & World Report: "Little more than a year after President Obama lifted a ban on federal funding for embryonic stem cell research, the administration is fighting to uphold its decision. The Justice Department is challenging a court ruling handed down last week by U.S. District Judge Royce Lamberth that froze federal funding for embryonic stem cell research. Lamberth's temporary injunction has put dozens of medical experiments on hold—including research on fighting spinal cord injuries, Parkinson's disease, diabetes, and other diseases. The department is seeking a stay of the court's injunction and has filed a notice of plans to take the decision to the U.S. Court of Appeals, should Lamberth stick to his ruling" (Haupt, 9/1).

Beth (not her real name) is a hard-working woman who is also homeless and on MassHealth. She strongly believes that dental care is the largest part of her health care, despite a complex combination of health issue, including HIV, asthma, and epilepsy.

During a recent stay at a local homeless shelter, Beth’s dentures were stolen. She has a great relationship with her dentist, and trusts him to properly treat her, since he understands her entire medical history. However, with the recent changes to MassHealth, she can no longer see her dentist to replace her stolen dentures- she must seek out care at a community health center, and is understandably very hesitant to change doctors.

Although she is worried about her own care, Beth also recognizes the difficulties that the cuts to MassHealth dental place on other residents in the Commonwealth. In particular, she is worried that elderly people will be unable to get dentures, which will impact their nutrition and lead to other health problems down the line.

Beth was willing to share her experiences with key decision-makers in the state at a recent hearing in Boston. Personal stories like these are crucial in showing community members, legislators, and other state officials why dental care is critical to overall health. For more information about how YOU can speak up for oral health, please visit www.hcfama.org/oralhealth.
-Christine Keeves

Today's headlines include reports about a new study examining the impact of the health overhaul on the small business workforce.

KHN Column: Debunking Medicare Myths
In his latest Kaiser Health News column, James Capretta writes: "Here's a puzzle: Critics say Medicare Advantage plans -- the private insurance options offered to beneficiaries -- are inefficient and costly. But those same critics oppose vouchers for Medicare -- even though that would set up a direct competition between the private plans and the traditional fee-for-service program. What are they afraid of?" (Kaiser Health News).

Health Insurance Tax Credit Likely To Affect Small Part Of Small-Business Workforce
About 16.6 million workers are employed by small businesses that are eligible for health insurance tax credits under the new health-care law, according to estimates that were to be released by a nonpartisan research foundation Thursday (The Washington Post).

More Workers At Small Businesses Will Get Medical Insurance Thanks to Healthcare Reform, Study Predicts
It's been nearly six months since the Patient Protection and Affordable Care Act of 2010 was signed into law, and it's still pretty unpopular. The Kaiser Health Tracking Poll for August found that 45% of Americans surveyed said they have a "somewhat unfavorable" or "very unfavorable" view of the law, compared with 43% who like it. A consensus of recent polls compiled by Pollster.com shows even more negativity – 48% of Americans oppose the law, compared with only 42% who favor it (Los Angeles Times).

Hospital Profits Raise Eyebrows As Medical Costs Continue To Soar
Forbes magazine this week released its first-ever survey of America's most profitable hospitals, revealing that 24 hospitals with more than 200 beds make 25 cents or more for every dollar of patient revenue they take in. The report is being widely disseminated by the health insurance industry, which is pushing back against claims that health insurance profits — rather than rising medical costs — are to blame for rising premiums (The Hill's Healthwatch). 

Desperate For A Treatment, One Physician Heals Himself
In late May this year, Dr. Stephane Huberty inserted a needle into his upper arm and injected himself with a cloudy white vaccine previously tested only on rats and dogs. The reason for this desperate measure: Dr. Huberty suffers from myasthenia gravis, a rare neurological condition. It is one of more than 5,000 "orphan" diseases, so called because there are so few sufferers that most pharmaceutical companies are reluctant to invest in cures (The Wall Street Journal).

Stem-Cell Plaintiffs Cite Ethical Motivation
The two scientists behind the lawsuit that has temporarily blocked federal funding for embryonic stem-cell research said Wednesday they were motivated by ethical objections to destroying human embryos for medical research (The Wall Street Journal).

Botox Maker To Pay $600 Million To Resolve Investigation
Allergan Inc., the maker of wrinkle-smoothing Botox, has agreed to pay $600 million to settle a yearslong federal investigation into its marketing of the top-selling, botulin-based drug (The Associated Press).

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