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Komen Says Planned Parenthood Will Still Be Eligible For Funding

Dr Joe — Fri, 03 Feb 2012 17:13:53 +0000

A Komen fundraising race from the fall. It hasn’t been a great week for Susan G. Komen for the Cure, the breast-cancer advocacy group known for its pink-ribbon fundraising efforts. Today the group reversed a decision — made public only Tuesday — to end Planned Parenthood’s eligibility for grants. Critics had said Komen planned to cut funding to the group for breast exams and education under pressure from anti-abortion organizations; Komen denied that. In a statement , Komen’s board and its founder and CEO, Nancy Brinker, apologized “to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women’s lives.” The statement continues: The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not. Komen’s short-lived move to defund Planned Parenthood spurred controversy , to put it mildly. Komen’s public rationale for its action changed over the week: A spokeswoman originally told the Associated Press it had changed its criteria to end grants to any organization under government investigation. But later in the week it said the decision sprang from a broader review of its criteria for grantees. Today it said it would “amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.” Planned Parenthood is the subject of a congressional investigation. Komen’s statement continues: Our only goal for our granting process is to support women and families in the fight against breast cancer. Amending our criteria will ensure that politics has no place in our grant process. We will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants, while maintaining the ability of our affiliates to make funding decisions that meet the needs of their communities. It is our hope and we believe it is time for everyone involved to pause, slow down and reflect on how grants can most effectively and directly be administered without controversies that hurt the cause of women. We urge everyone who has participated in this conversation across the country over the last few days to help us move past this issue. We do not want our mission marred or affected by politics — anyone’s politics. Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work. We ask for the public’s understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve. We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern. Planned Parenthood, in a statement , said it is “enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers. What these past few days have demonstrated is the deep resolve all Americans share in the fight against cancer, and we honor those who are at the helm of this battle.” So, readers, have the week’s events changed your opinion of Susan G. Komen for the Cure? Photo: Associated Press

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Komen Says Planned Parenthood Will Still Be Eligible For Funding

A.M. Vitals: Prostate-Cancer Drugs Improve Survival in Trials

Martin Neumann — Wed, 01 Feb 2012 14:16:48 +0000

Prostate-Cancer Drug Studies: The results from two trials of experimental drugs for advanced prostate cancer add to recent progress against the disease, the WSJ reports . Medivation’s MDV3100 extended survival by nearly five months in a 1,199-patient study, while Bayer and Algeta’s Alpharadin, which homes in on cancer that has already spread to the bone, boosted survival by almost three months in a 922-patient study, the paper reports. No Consensus on Repeat Breast-Cancer Surgery: Rates of repeat lumpectomies vary widely from doctor to doctor, according to a study published in JAMA, and averaged 22.9%, the New York Times reports . There is no broad agreement on when a second surgery — intended to make sure all cancer has been excised — is necessary. The study found that almost half of the repeat surgeries were in women whose lab reports showed no cancer had been left behind, while 14% of patients who did have some remaining traces of cancer did not receive a follow-up surgery to remove it, the NYT reports. Birth-Control Recall: Pfizer is recalling about a million blister packs of birth-control pills because of packaging errors, including in some cases a lack of enough active tablets to prevent pregnancy, Time’s Healthland blog reports . Pfizer says 14 lots of Lo/Ovral-28 tablets and 14 lots of generic Norgestrel and Ethinyl Estradiol tablets with expiration dates ranging from July 31, 2013, to March 31, 2014 were affected, and that women who have been taking the pills should use back-up, non-hormonal birth control, Time says. Grants Are Cut Off: Susan G. Komen For the Cure is ceasing hundreds of thousands of dollars in grants to Planned Parenthood affiliates for activities including breast exams and breast-cancer education, the WSJ reports . Komen said in a statement that had “implemented more stringent eligibility and performance criteria” for its grant programs. Planned Parenthood, which is being investigated by a Republican member of Congress about its compliance with federal restrictions on funding abortion, says Komen “appears to have succumbed to political pressure.” The Associated Press first reported Komen’s move. Image: iStockphoto

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A.M. Vitals: Prostate-Cancer Drugs Improve Survival in Trials

Health Spending Growth Slowed in 2010 — Was It All Because of the Economy?

Martin Neumann — Tue, 10 Jan 2012 14:22:34 +0000

The latest national health spending figures out Monday show slowed growth in medical expenditures in 2010 — and plenty of debate fodder for both policy wonks and political partisans. For a start, there’s little consensus among analysts over the causes of the slowdown. Republicans are seizing on the explanation that it’s the product of an economic downturn (which they blame on President Barack Obama). The Obama administration “really can’t claim any credit unless it’s to say, ‘We broke the economy and you can thank us for that,’ says Douglas Holtz-Eakin, an economist who advised 2008 Republican presidential candidate John McCain. “Spending growth was slower than projected NOT because Obamacare worked, but because the Obama ‘stimulus’ didn’t,” emails Chris Jacobs, health policy analyst for the Republican Policy Committee, a group of Senate lawmakers. But Ezekiel Emanuel, a bioethicist and professor at the University of Pennsylvania who previously advised the Obama administration on health policy, says that the economy may not have been the only factor in lowering health costs and that national debates over the health-care overhaul may have sparked closer examination by the health care industry of ways to become more efficient. “Around health care reform discussions, you get a detailed exploration of what we’re doing that may lead to decreased costs,” he says. Then there’s a question about whether the slowed growth is permanent. Princeton University economist Uwe Reinhardt cautions against anyone planning “to break out the champagne too quickly to celebrate the slaying of the health care cost growth monster.” “What happened over 2009-2010 is not necessarily a portent of things to come over the decade,” he writes. ( Growth in health spending slowed in 2009 as well.) What’s more, health-care analysts are also at odds over whether slower growth in medical spending is a good thing. Marilyn Moon, a Medicare expert at the American Institutes for Research in Washington, warns that “postponing care or forgoing drugs that are preventive in nature will raise health care costs over time and hurt the health of the population affected.” On the other hand, Michael Cannon, director of health policy at the libertarian Cato Institute, says there is “a lot of evidence that when individuals … are rationing their own care, they do a fairly good job of weeding out the unnecessary stuff” and that they may even end up healthier for it. Bonus: Reined-In Demand For Health Care Is Here to Stay: Moody’s Image: iStockphoto

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Health Spending Growth Slowed in 2010 — Was It All Because of the Economy?

Immune Response of the Body against Cancer

Dr Joe — Wed, 28 Dec 2011 10:11:52 +0000

Every year, there are reported cases of individuals who are diagnosed of having cancer. And, although there were already studies which focused its attention on the major risk factors that can be contributory to the initiation of the over growth of cells which results to the malignancy known as cancer, still the reason behind the Related posts: Study: Tumor’s Response To Treatment May Be Measured Optically Cancer has always been known to be a deadly disease…. Our immune system, responsible for deadly flu Current research published in the ‘Cell’ journal says flu infections… ESOMO 35: Chemotherapeutical Phase III Trial Shows Positive Response to Treat Multiple Myeloma According to the study done by the 35th Congress of…

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Immune Response of the Body against Cancer

A.M. Vitals: Wal-Mart, Supervalu Pull Some Enfamil From Shelves

Dr Joe — Fri, 23 Dec 2011 14:03:36 +0000

Focus on Formula: Wal-Mart and Supervalu have removed certain containers of Mead Johnson Nutrition’s Enfamil infant formula from their store shelves following the death of a Missouri infant from a rare bacterial infection, the WSJ reports . The FDA is testing the formula for the presence of the Cronobacter sakazakii bacteria that killed the infant. Another infant in the state survived after being infected by the bacteria after consuming an undisclosed brand of formula, the paper says. A Mead Johnson spokesman says the company’s pre-sale testing showed no traces of the bacteria. Precautionary Removal: France’s health minister is urging tens of thousands of women to have their breast implants removed, saying the products — made by Poly Implant Prothese — used substandard silicone and are subject to rupture and leakage, the WSJ reports . No association between cancer and the implants has been found. The implants weren’t sold in the U.S. but were sold in other countries. Short-Term Doc Fix: House Speaker John Boehner agreed to extend the payroll tax break by two months in a deal that will also push off a scheduled 27% cut to Medicare reimbursement for doctors, the WSJ reports . In a statement, the American Medical Association called the two-month extension a “brief reprieve” and urged Congress to enact “a real and fiscally responsible solution” to what has become a parade of short-term patches for the flawed Medicare reimbursement formula. Bolstering Funds: The federal government has shored up the high-risk health insurance pools in New Hampshire and California to make sure the funds last until 2014, Kaiser Health News reports . Both states say their pools, for people who lack insurance and have difficulty getting it because they have pre-existing conditions, may start to run low on funds early in 2012, KHN says. Image: iStockphoto

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A.M. Vitals: Wal-Mart, Supervalu Pull Some Enfamil From Shelves

Will Santa Bring a Last-Minute Doc Fix?

Dr Joe — Wed, 21 Dec 2011 17:10:52 +0000

A doc fix is looking like an increasingly unlikely holiday present for the nation’s physicians — and the patients they treat. Last year at this time a one-year patch for scheduled cuts to Medicare reimbursement was all squared away with a bow on top. But it’s been a different story in 2011: as the Associated Press reports , Congress has not yet acted to push off a reimbursement cut of about 27%. That means unless something is done, those cuts will kick in next month. The cuts are officially scheduled to take place Jan. 1, but Medicare has told physicians that without a fix the program will hold claims for the first 10 business days of next year, the AP says. That takes us to Jan. 18, thanks to the New Year’s Day and Martin Luther King Day holidays. The doc fix itself isn’t particularly controversial — no one thinks it’s a viable strategy to let the cuts go into effect. (Nor does anyone think the current reimbursement formula, which regularly gets us into this mess, is sustainable; the question is how to pay for a permanent fix .) But the current patch is being considered as part of the debate over whether to extend the payroll tax cut, as Bloomberg News explains . A spokesman for House Speaker John Boehner tells BN House Republicans have no plans to move a stand-alone bill. The WSJ has more on the standoff over the payroll-tax break. We mentioned earlier that a failure to pass a fix might affect patients as well as their physicians. That would happen if doctors’ reimbursements were cut and they decided not to accept Medicare patients for the time being. Yesterday, the American Association of Family Physicians said it was “outraged” that Congress had failed to pass a fix. Image: iStockphoto

GAO Report Blames Drug Shortages On Manufacturing Problems

Martin Neumann — Thu, 15 Dec 2011 04:59:38 +0000

Central to the drug-shortage issue is a chicken-and-egg question that often leaves legislators scratching their heads at congressional hearings. Chicken: Are the shortages of crucial drugs caused by factory flaws and shutdowns? Or egg: Are shortages somehow caused by economics, like the thin profit margins of generic drugs? A federal report to be released Thursday comes down with both feet in the chicken camp. “Manufacturing problems were the primary cause of most shortages,” says an analysis by the Government Accountability Office. And how to fix this problem? The GAO’s answer is in its title: “Drug Shortages: FDA’s Ability to Respond Should be Strengthened.” The number of crucial-drug shortages, especially among cancer drugs and nutritional products, has risen, the GAO found. The number of crucial-drug shortages has more than tripled since 2006, it says. (The WSJ reports today on the shortage of nutrition drugs.) The GAO says the one fix lies in giving the Food and Drug Administration more information and more authority. There needs to be a law compelling companies to notify the FDA early when they run into manufacturing snafus that will cause production to shut down, the audit found. “Most drug shortages we reviewed in detail were reportedly caused by manufacturing problems, including those that resulted in manufacturing shutdowns,” GAO investigators told the senators who commissioned the report. Other shutdowns stemmed from disruptions in supply of the drugs’ raw materials. And those, too, were caused by factory quality problems and “unspecified manufacturing delays,” the GAO concludes. But the FDA can’t fix problems it doesn’t know about, the audit found. “FDA is constrained by its lack of authority to require manufacturers to provide the agency and the public with information about shortages, or require that manufacturers take certain actions to prevent, alleviate or resolve shortages,” GAO investigators conclude. Their report was requested by Sens. Tom Harkin, Richard Blumenthal and Robert P. Casey Jr., all Democrats. Iowa’s Sen. Harkin, chairman of the Senate Committee on Health, Education, Labor and Pensions, said the report “confirms that life-threatening drug shortages are becoming more prevalent, and are caused or exacerbated by disruptions in the drug supply chain, manufacturing problems, and communication breakdowns.” The Senate committee is holding a hearing on the topic Thursday. Sen. Blumenthal, of Connecticut, said the report “provides more proof that proactive steps are urgently needed to stem the severe public health crisis caused by a drug shortage epidemic that is escalating health care costs and preventing life-saving drugs from reaching patients.” He continued: “Aggressive measures are necessary to crack down on anti-consumer practices promoted by so-called ‘gray markets’ that inflate prices, creating a public health menace.” When the FDA knows of potential shortages, it has the discretion to prevent or alleviate them with steps such as allowing foreign-approved drugs into the U.S. The GAO audit also found that the FDA can even use its discretion to allow drugs with quality problems to be sold if the manufacturer develops a method to fix the problem before the drug is used. The audit found that that the majority, 68%, of the shortages in the past three years have been injectable medicines, especially generics. Drugs for cancer showed the biggest percentage increase in numbers of shortages, followed by endocrine and nutritional products. Another factor that didn’t help: “FDA did not have a database containing information on drug shortages for the time period we reviewed,” GAO investigators found. So it had to turn to drug-shortage information compiled by the University of Utah and by an association of health-system pharmacists. Image: iStockphoto

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GAO Report Blames Drug Shortages On Manufacturing Problems

Insurance Brokers Get No Love in Medical Loss Ratio Rule

Dr Dreams — Fri, 02 Dec 2011 20:13:30 +0000

The health-care overhaul law includes a provision requiring insurers to spend a certain proportion of premium dollars on patient care and quality-improvement programs. It all sounds straightforward enough — large-group plans must spend at least 85% and individual and small-group plans, 80% — but the devil is always in the details. And insurance agents and brokers have been hoping that HHS would revise those details to remove their commissions from the administrative-cost bucket. Their argument: insurers seeking to meet the MLR targets will squeeze commissions, hurting agents and brokers as well as the customers they serve. But commissions were classified as an administrative cost when the Obama administration issued its rule on the MLR last year . And revisions made to the rule issued by HHS today made no change to that policy. The National Association of Insurance Commissioners, which represents state insurance regulators, recently voted to support a resolution urging Congress to amend the law “in order to preserve consumer access to agents and brokers.” It also suggested that HHS could take a variety of actions to help agents, including counting some agent activities and compensation as quality-related for purposes of MLR calculations. (Here’s the resolution , which passed by a narrow margin.) In an emailed statement, the president of the National Association of Insurance and Financial Advisors, Robert Miller, says the group “is disappointed that the Administration rejected the NAIC recommendation to take action that would ensure continued consumer access to professional health insurance agents” in its final rule. But the group “remains hopeful that Congress will join the NAIC in recognizing the harm caused to consumers and make the necessary changes to the law.” One modification that was made to the law: the rebates that consumers will get if their plan doesn’t adhere to the MLR requirements will be tax-free. Image: iStockphoto

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Insurance Brokers Get No Love in Medical Loss Ratio Rule

Back on the ‘Doc Fix’ Watch as Medicare Cuts Loom

Dr Dreams — Mon, 28 Nov 2011 18:23:46 +0000

It seems like just yesterday that Congress passed a one-year fix for Medicare reimbursement cuts. Unfortunately, time has flown, and we find ourselves back on the “doc fix” watch — though this year, there’s a 24.7% cut looming. (Last year, it was 20%; every time cuts are put off, cuts for the next potential round get bigger.) The current (and unsustainable) payment formula pegs the increase in Medicare reimbursement to the GDP. That’s problematic, since growth in health-care spending outstrips growth in GDP . Automatic cuts kick in if spending reaches a certain level. The deficit-reduction supercommittee, which wrapped up last week without an agreement on budget cuts, failed to find a long-term solution to the problem. As the Associated Press reports , Congress must act before Jan. 1 to keep physicians from facing the cuts, and their options include both one-year and two-year fixes. But they must be paid for — about $22 billion for the one-year and $35 billion for the two-year fix. And these are just patches until a far pricier permanent solution is found. We’ll keep tabs on the doc fix goings-on as the deadline approaches. Image: iStockphoto

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Back on the ‘Doc Fix’ Watch as Medicare Cuts Loom

Insurance Commissioners Call For Another Look at Medical Loss Ratio

Martin Neumann — Wed, 23 Nov 2011 15:47:18 +0000

One of the most closely-watched aspects of the federal health-overhaul law is a provision that requires insurers to spend a set proportion of premium dollars on patients’ care and quality-improvement efforts — 85% for large groups, or 80% for individual and small-group plans. If an insurer doesn’t hit the mark, it has to refund the difference to consumers. That issue seemed to have been largely resolved last November, when the Department of Health and Human Services released a rule on how the so-called medical loss ratio would be calculated. The first rebates are set to be issued next year. Now, some state regulators want to reopen the whole can of worms. Yesterday, the National Association of Insurance Commissioners — which represents state insurance regulators — voted to support a resolution urging Congress to amend the law “in order to preserve consumer access to agents and brokers.” Underlying the resolution is concern that the MLR requirements are squeezing the commissions earned by brokers and agents, as insurers work to keep their administrative expenses down and avoid rebates. The HHS rule issued last November was based largely on an NAIC-endorsed model — one that didn’t include a proposal that would have removed commissions from the administrative-cost bucket. The resolution also suggests that HHS should take action to help agents. That could include granting states waivers that delay the MLR rules; putting a hold on aspects of the federal loss-ratio requirement and classing some agent activities and compensation as quality-related for MLR purposes, the NAIC said. HHS is already weighing a number of states’ MLR waiver requests. The resolution was controversial. It passed the NAIC relatively narrowly, with 26 regulators supporting it, 20 opposing it and 5 abstaining. In an interview with the Health Blog this morning, Florida Insurance Commissioner Kevin McCarty, one of the resolution’s drafters and the president-elect of the NAIC, said it reflects “the critical role that agents play, not only at the point of sale, but in following up afterward,” because they help clients understand their benefits and access care after they buy plans. He’s worried that, particularly in the individual market, agents won’t be able to stay in business if commissions continue to be reduced, he said. He also pointed to past NAIC letters (see here and here ) that flagged the importance of agents. Those who opposed the resolution argued that it would effectively cut consumers’ rebates to benefit agents. California Insurance Commissioner Dave Jones said in a statement that consumers were “ill served by the proposal.” It’s also not clear that the vote will have any concrete impact, since Congress or HHS would have to take action to implement it. An HHS spokeswoman said in a statement that “agents and brokers play an essential role in the insurance marketplace and we have implemented the law in a way that has maintained consumer access to their services.” Regulators will “review the recommendations” of the NAIC and “continue to work with them as well as consumer groups and other stakeholders,” she said. Update: This post has been updated with comment from Kevin McCarty. Image: iStockphoto

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Insurance Commissioners Call For Another Look at Medical Loss Ratio